Abandono del tabaco y riesgo de nuevo infarto en pacientes coronarios: estudio de casos y controles anidado

Serrano, M.; Madoz, Edurne; Ezpeleta, Isabel Gárriz; Julián, Beatriz San; Amézqueta, C.; Marco, José Antonio Pérez; Irala, Jokin de

doi:10.1016/s0300-8932(03)76898-5

Cited by 31 publications

(8 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A more appropriate method would be to categorize never smokers, former smokers, and current smokers separately in our statistical analyses. It may be plausible that the effects of smoking on cognition may not be evident in former smokers who have recovered from the detrimental effects of smoking, similar to how cessation of smoking is associated with reduced risk of lung cancer 50 and cardiovascular disease 51 . Another limitation was the lack of data on quantity of tobacco use (ie, pack-years) and exposure to second-hand smoke.…”

Section: Discussionmentioning

confidence: 99%

Tobacco Use in Fibromyalgia Is Associated With Cognitive Dysfunction

Lin

D’Souza

et al. 2019

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

View full text Add to dashboard Cite

Objective To evaluate the association between smoking and cognitive function in patients with fibromyalgia. Patients and Methods We surveyed 668 patients with fibromyalgia from May 1, 2012 through November 30, 2013 at a major tertiary referral center. Patients were categorized by smoking status. Primary outcome of interest was cognitive function (MASQ questionnaire), and secondary outcomes included fibromyalgia symptom severity (FIQ-R questionnaire), quality of life (SF-36 questionnaire), fatigue (MFI-20 questionnaire), sleep (MOS-sleep scale), anxiety (GAD-7 questionnaire), and depression (PHQ-9 questionnaire). Independent Students' t -tests and χ 2 tests were performed for continuous and categorical variables, respectively. Univariate regression analysis identified variables predictive of outcomes, adjusting for age, gender, body mass index, marital status, and educational level. Results Ninety-four (14.07%) patients self-identified as smokers. There was an association of lower education level, unmarried status, and younger age in smokers compared with nonsmokers. In the adjusted univariate regression analysis, fibromyalgia smokers reported greater perceived total cognitive dysfunction ( P =.009) and greater subscale scores of perceived difficulty in language ( P =.03), verbal memory ( P =.003), visual-spatial memory ( P =.02), and attention ( P =.04) compared with nonsmokers with fibromyalgia. For secondary outcomes, smokers with fibromyalgia reported greater severity of fibromyalgia-related symptoms ( P =.006), worse quality-of-life index in the mental component scale ( P =.02), greater sleep problems ( P =.01), and increased anxiety ( P =.001) compared with nonsmokers who had fibromyalgia. Conclusion In patients with fibromyalgia, smoking is a risk factor for cognitive dysfunction. Moreover, smokers with fibromyalgia were more likely to report increased severity of fibromyalgia symptoms, worse quality of life, more sleep problems, and increased anxiety compared with nonsmokers with fibromyalgia.

show abstract

Section: Discussionmentioning

confidence: 99%

Tobacco Use in Fibromyalgia Is Associated With Cognitive Dysfunction

Lin

D’Souza

et al. 2019

Mayo Clinic Proceedings: Innovations, Quality & Outcomes

View full text Add to dashboard Cite

show abstract

“…Continuing to smoke after a coronary event is associated with mortality levels that are significantly higher than the mortality levels among those who quit. In addition, smoking cessation rapidly reduces the risk of a coronary event once smoking stops, with the risk of such an event approaching that of non-smokers by 3 years after cessation [3–5]. A meta-analysis of cohort studies assessing the effects of smoking cessation on mortality after a myocardial infarction estimated that the combined odds ratio of death for smoking cessation compared with smoking continuation was 0.54 (95% confidence interval [CI], 0.46–0.62) [6].…”

Section: Introductionmentioning

confidence: 99%

Income-related inequality in smoking cessation among adult patients with cardiovascular disease: a 5-year follow-up of an angiography intervention in Luxembourg

Tchicaya

Lorentz

Demarest

2017

BMC Cardiovasc Disord

View full text Add to dashboard Cite

BackgroundSmoking contributes to cardiovascular diseases (CVD), a leading cause of death and a large source of healthcare costs in Western countries. We examined the association between income and smoking cessation among smokers who underwent coronary angiography at the National Institute for Cardiac Surgery and Interventional Cardiology in Luxembourg.MethodsData were derived from a follow-up study conducted in 2013/2014 among 4391 patients (of which 1001 patients were smokers) at the time of coronary angiography in 2008/2009. Four logistic regression models were applied. In three models, the predictor was income and the covariates were sex, age, nationality, marital status, diagnosis, body mass, physical activity, and awareness of tobacco as a cardiovascular (CV) risk factor. In the other model, the predictor was an interaction term composed of income and awareness of tobacco as a CV risk factor; the other variables were covariates.ResultsAmong patients who were current smokers at baseline, 43.2% were current smokers at follow-up and 56.8% had quit smoking. In the multivariate logistic models, quitting smoking was associated with income even after controlling for socio-demographic, diagnostic, and behavioural risk factors. In the full model, the odds of quitting smoking among patients in the two highest income categories remained significant when compared to patients in the lowest income category: odds ratio (OR) = 2.8; 95% confidence interval (CI), 1.3–6.1 and OR = 2.8; 95% CI, 1.2–6.5, respectively. In the full model with an interaction term, quitting smoking was only associated with income when patients knew tobacco was a CV risk factor. The odds of smoking cessation were 5.62 (95% CI: 2.13–14.86) and 3.65 (95% CI: 1.51–8.86) times for patients with annual incomes of 36,000–53,999€ and ≥54,000€, respectively), compared to those for patients with an annual income of <36,000€.ConclusionsThis study highlights the influence of income on behaviours regarding CVD risk factors after a major CVD event. Patients in the highest income groups were more likely to quit smoking, although only when they were aware of tobacco as a CV risk factor. Therefore, intervention strategies targeting lower income groups should be implemented in major health facilities.

show abstract

“…A atividade fibrinolítica endógena diminui em decorrência da inibição da liberação de fatores derivados do endotélio, como o tPA, precipitando disfunção endotelial e predispondo a formação de trombos que ocluem áreas quase sempre já parcialmente obstruídas por placas ateromatosas. Dessa forma, o risco de desenvolver infarto do miocárdio é três vezes maior em pacientes que continuam a fumar após um evento coronariano, comparativamente a pacientes que abandonam o fumo 491 .…”

Section: Prevenção Secundária 71 -Tabagismounclassified

Diretrizes

2009

Arq. Bras. Cardiol.

View full text Add to dashboard Cite

-Atendimento pré-hospitalarO interesse no atendimento pré-hospitalar do infarto agudo do miocárdio (IAM) teve início na década de 1960, devido ao grande número de óbitos que ocorriam antes que os paciente chegassem ao hospital.A maioria das mortes por IAM ocorre nas primeiras horas de manifestação da doença, sendo 40%-65% dos casos na primeira hora e, aproximadamente, 80% nas primeiras 24 horas [1][2][3] . Assim, a maior parte das mortes por IAM acontece fora do ambiente hospitalar, geralmente desassistidas pelos médicos 4 . A modalidade mais frequente de parada cardiorrespiratória nas primeiras horas do IAM é a fibrilação ventricular 3 . -Período pré-hospitalar.O período pré-hospitalar compreende dois momentos: a) do início dos sintomas (geralmente dor torácica aguda) até a decisão de procurar atendimento; b) da decisão de procurar atendimento até a chegada ao hospital.No infarto agudo do miocárdio com elevação do segmento ST (IAMCST), o tempo desde o início dos sintomas (oclusão da artéria coronária) até a instituição do tratamento (reperfusão química ou mecânica) é diretamente proporcional à ocorrência de eventos clinicamente relevantes. Esse tempo é fator fundamental para o benefício do tratamento, tanto imediato quanto tardio 5 .No entanto, sabe-se que a fase pré-hospitalar (em ambos os momentos descritos) é caracterizada por ser demorada, especialmente em pacientes idosos, do sexo feminino e com baixa condição socioeconômica 4 . Alguns fatores estão relacionados ao aumento desse tempo tão precioso (Quadro 1.1.1.1) 6 . O componente pré-hospitalar no atraso do atendimento ao paciente com dor torácica é de tal magnitude que, na prática clínica, apenas cerca de 20% destes pacientes chegam ao setor de emergência com até duas horas após o início dos sintomas 7 . -Medidas na fase pré-hospitalarApesar da significativa redução da mortalidade hospitalar do IAM nas últimas décadas 8,9 , houve pouco avanço no conhecimento sobre a epidemiologia e o tratamento na fase pré-hospitalar. É notória a necessidade de mudanças nesse cenário, embora poucas sejam as evidências geradas para este fim.A abordagem do paciente com suspeita de síndrome coronária aguda em ambiente extra-hospitalar deve, idealmente, ser feita por profissional de saúde, com realização de uma história clínica direcionada, investigando as características dos sintomas atuais (momento do início, tempo de duração, qualidade, intensidade, relação com o esforço e repouso) e a presença de doença coronária estabelecida (angina prévia). Algumas características são reconhecidamente determinantes para a manifestação atípica de um evento coronariano e devem ser lembradas quando um indivíduo for abordado na fase pré-hospitalar, por mascararem o quadro de IAM (Tabela 1.1.2.1) [10][11][12] .O eletrocardiograma executado no local de atendimento e interpretado por um médico habilitado (na ambulância ou em local remoto) mostrou ser um método que reduz em 34% o tempo porta-agulha e em 18% o tempo porta-balão, além de proporcionar maiores taxas de tempo porta-balão ideal (men...

show abstract

Abandono del tabaco y riesgo de nuevo infarto en pacientes coronarios: estudio de casos y controles anidado

Cited by 31 publications

References 26 publications

Tobacco Use in Fibromyalgia Is Associated With Cognitive Dysfunction

Tobacco Use in Fibromyalgia Is Associated With Cognitive Dysfunction

Income-related inequality in smoking cessation among adult patients with cardiovascular disease: a 5-year follow-up of an angiography intervention in Luxembourg

Diretrizes

Contact Info

Product

Resources

About