Circulation:吸烟可影响循环中心肌肌钙蛋白I的浓度?

2016-11-05 xing.T MedSci原创

当前吸烟与低浓度的cTnI相关,表明烟草烟雾中的物质可能影响心肌细胞损伤。相比于当前吸烟者,在从不吸烟者/以往吸烟者中cTnI水平与心血管终点事件之间的相关性更强,这与当前吸烟对心血管的不良管影响是通过非亚临床心肌损伤机制介导的理论一致。

吸烟和循环中心肌肌钙蛋白I(cTnI)水平都与急性心肌梗死(AMI)、心力衰竭(HF)和心血管死亡的风险相关。然而,cTnI的水平是否会随着吸烟状况的改变而改变,或吸烟是否会改变心肌肌钙蛋白I和临床结局之间的预后关系仍不清楚。最近,心血管领域权威杂志Circulation上发表了来自挪威奥斯陆大学、挪威与心力衰竭研究中心心内科Magnus N. Lyngbakken医生及其研究团队的研究文章,旨在明确吸烟与cTnI的关系。

该研究收集了大样本队列中的数据,研究者评估了吸烟和cTnI之间的关联,并探究了吸烟对cTnI水平、AMI、HF和心血管死亡率之间的影响。他们采用高灵敏度的检测方法测量了3824例从不吸烟者、2341例以往吸烟者和2550例当前吸烟者循环中的cTnI 水平。在研究之初所有受试者均无已知的心血管疾病(CVD)和糖尿病。

所有受试者年龄从19~94岁,55.5%为女性参与者。研究者发现,相比于从不吸烟者(中位数为3.2 [四分位数间距范围2.2-4.7] ng/L;P<0.001)和以往吸烟者(中位数为3.4 [四分位数间距范围2.3-5.0] ng/L;P<0.001),当前吸烟者循环中cTnI水平显著降低(中位数为2.9 [四分位数间距范围2.0-4.1] ng/L)。调整潜在的混杂因素后,这种相关性仍然显著(0.098,95%置信区间为-0.129至-0.068)。


研究者观察到在总体研究人群中增加的cTnI浓度和临床终点事件之间的关联(调整后的危险比为1.38,95%置信区间为1.25-1.51)。而在当前吸烟者中,这种相关性有所减弱(调整后的危险比为1.18,95%置信区间为0.98-1.41),并明显弱于从不/以往吸烟者(P交互作用=0.003)。研究者采用C-统计方法来评估预后的准确性,发现当前吸烟者明显低于从不吸烟者(P<0.001)。另外,在当前吸烟者中,cTnI没有提供更多的预后信息来进行Framingham心血管疾病风险评分(P=0.08)。

由此可见,当前吸烟与低浓度的cTnI相关,表明烟草烟雾中的物质可能影响心肌细胞导致损伤。相比于当前吸烟者,在从不吸烟者/以往吸烟者中cTnI水平与心血管终点事件之间的相关性更强,这与当前吸烟对心血管的不良管影响是通过非亚临床心肌损伤机制介导的理论一致。

原始出处:

Magnus N.Lyngbakken, et al. Impact of Smoking on Circulating Cardiac Troponin I
Concentrations and Cardiovascular Events in the General Population: The HUNT
Study.
Circulation. November 4, 2016.  http://dx.doi.org/10.1161/CIRCULATIONAHA.116.023726

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    2016-11-13 一个字-牛

    戒烟吧

    0

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    2016-11-06 榄枷檬

    烟盒上大字标着吸烟有害健康,人们还是对它视而不见!!

    0

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