Prognosis after switching to electronic cigarettes following percutaneous coronary intervention: a Korean nationwide study.

IF 37.6 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

European Heart Journal Pub Date : 2025-01-03 DOI:10.1093/eurheartj/ehae705

Danbee Kang, Ki Hong Choi, Hyunsoo Kim, Hyejeong Park, Jihye Heo, Taek Kyu Park, Joo Myung Lee, Juhee Cho, Jeong Hoon Yang, Joo-Yong Hahn, Seung-Hyuk Choi, Hyeon-Cheol Gwon, Young Bin Song

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引用次数: 0

Abstract

Background and aims: Despite the increasing popularity of electronic cigarettes (E-cigarettes), the prognostic impact of switching to E-cigarettes in smokers with coronary artery disease who have undergone percutaneous coronary intervention (PCI) remains unclear.

Methods: Using a nationwide cohort from the Korean National Health Insurance database, 17 973 adults (≥20 years) identified as smokers (based on a health screening examination within 3 years before PCI) who underwent health screening within 3 years after PCI were enrolled to determine changes in smoking habits. Patients were classified as continued combustible cigarette users, successful quitters, or switchers to E-cigarettes. The group switching to E-cigarettes was further divided into dual users (using both combustible and E-cigarettes) and those exclusively using E-cigarettes. Primary outcomes included major adverse cardiac events (MACEs), a composite of all-cause death, spontaneous myocardial infarction, and repeat revascularization.

Results: Among the total population, 8951 patients (49.8%) continued using combustible cigarettes, 1694 (9.4%) were switched to E-cigarettes, and 7328 (40.7%) successfully quit smoking after PCI. During a median follow-up of 2.4 years, the cumulative incidence of MACE was lower among E-cigarette switchers (10%) or quitters (13.4%) than among continued combustible cigarette users (17%). When continued combustible cigarette users were used as the reference, the multivariable-adjusted hazard ratios with 95% confidence intervals for MACE were 0.82 (0.69-0.98) for switchers to E-cigarettes and 0.87 (0.79-0.96) for successful quitters. Compared with dual users, entirely switching to E-cigarettes was associated with a significantly lower MACE risk (hazard ratio 0.71; 95% confidence interval 0.51-0.99).

Conclusions: Among smokers who underwent PCI for coronary artery disease, switching to E-cigarette use (particularly complete transition) or quitting smoking was associated with reduced MACE risk than with continued combustible cigarette use.

Clinical trial registration: ClinicalTrials.gov NCT06338761.

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经皮冠状动脉介入治疗后改吸电子烟的预后：一项韩国全国性研究。

背景和目的：尽管电子烟（E-cigarettes）越来越受欢迎，但接受经皮冠状动脉介入治疗（PCI）的冠心病吸烟者改用电子烟对预后的影响仍不清楚：利用韩国国民健康保险数据库中的全国性队列，对17 973名被确认为吸烟者（根据PCI前3年内的健康检查）且在PCI后3年内接受过健康检查的成年人（≥20岁）进行了登记，以确定其吸烟习惯的变化。患者被分为继续使用可燃卷烟者、成功戒烟者或改用电子烟者。改用电子烟的患者又分为双重使用者（同时使用可燃卷烟和电子烟）和只使用电子烟的患者。主要结果包括主要心脏不良事件（MACE），即全因死亡、自发性心肌梗死和再次血管重建的综合结果：PCI术后，8951名患者（49.8%）继续使用可燃卷烟，1694名患者（9.4%）改用电子烟，7328名患者（40.7%）成功戒烟。在中位 2.4 年的随访期间，电子烟转换者（10%）或戒烟者（13.4%）的 MACE 累计发生率低于继续使用可燃卷烟者（17%）。如果将继续吸食可燃卷烟者作为参照，那么改吸电子烟者的 MACE 多变量调整危险比（95% 置信区间）为 0.82（0.69-0.98），成功戒烟者的 MACE 多变量调整危险比（95% 置信区间）为 0.87（0.79-0.96）。与双重吸烟者相比，完全改用电子烟的患者MACE风险显著降低（危险比为0.71；95%置信区间为0.51-0.99）：结论：在因冠状动脉疾病接受PCI治疗的吸烟者中，与继续使用可燃卷烟相比，改用电子烟（尤其是完全改用）或戒烟可降低MACE风险：临床试验注册：ClinicalTrials.gov NCT06338761。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Heart Journal 医学-心血管系统

CiteScore

39.30

自引率

6.90%

发文量

3942

审稿时长

1 months

期刊介绍： The European Heart Journal is a renowned international journal that focuses on cardiovascular medicine. It is published weekly and is the official journal of the European Society of Cardiology. This peer-reviewed journal is committed to publishing high-quality clinical and scientific material pertaining to all aspects of cardiovascular medicine. It covers a diverse range of topics including research findings, technical evaluations, and reviews. Moreover, the journal serves as a platform for the exchange of information and discussions on various aspects of cardiovascular medicine, including educational matters. In addition to original papers on cardiovascular medicine and surgery, the European Heart Journal also presents reviews, clinical perspectives, ESC Guidelines, and editorial articles that highlight recent advancements in cardiology. Additionally, the journal actively encourages readers to share their thoughts and opinions through correspondence.