Bock, D. and Senges, J. and Pohlmann, C. and Hochadel, M. and Muenzel, T. and Giannitsis, E. and Schmitt, C. and Heusch, G. and Voigtlaender, T. and Mudra, H. and Schumacher, B. and Darius, H. and Maier, L. S. and Hailer, B. and Haude, M. and Gohlke, H. and Hink, U. (2020) The German CPU registry: Comparison of smokers and nonsmokers. HERZ, 45 (3). pp. 293-298. ISSN 0340-9937, 1615-6692
Full text not available from this repository. (Request a copy)Abstract
Background Chest pain is a major reason for admission to an internal emergency department, and smoking is well-known risk factor for coronary artery disease (CAD) and acute coronary syndrome (ACS). The aim of this analysis is to illustrate the differences between smokers and nonsmokers presenting to German chest pain units (CPU) in regard to patient characteristics, CAD manifestation, treatment strategy, and prognosis. Methods From December 2008 to March 2014, 13,902 patients who had a complete 3-month follow-up were enrolled in the German CPU registry. The analysis comprised 5796 patients with ACS and documented smoking status. Results Of all the patients in the CPU registry, 35.2% were smokers. Compared with nonsmokers, they were 13.5 years younger (58.2 vs. 71.7 years, p < 0.001), predominantly men (77.1% vs. 65.2%, p < 0.001), and were more frequently diagnosed with single-vessel disease (32.1% vs. 25.2%) as well as ST-elevation myocardial infarction (STEMI; 23.8% vs. 15.5%, p < 0.001). Although the Global Registry of Acute Coronary Events (GRACE) Risk Score for hospital mortality was lower in the group of smokers (106.1 vs. 123.3, p < 0.001), we did not observe any differences in CPU death (0.4% vs. 0.4%, p = 0.69) and CPU major adverse cardiac event (MACE) rates (3.8% vs 2.9%, p = 0.073) between the groups. In the 3-month follow-up, we documented higher mortality rates in the nonsmoker group (1.9% vs. 2.9%, p = 0.035) in correlation with the GRACE Risk Score (80.3 vs. 105.2, p < 0.001). MACE rates were similar during the follow-up (3.1% vs. 4.1%, p = 0.065). Conclusion Observations from the German CPU registry demonstrate that smoking is a strong predictor of acute CAD manifestation early in life, especially STEMI. In spite of a lower GRACE Risk Score and fewer comorbidities, smokers had a rate of hospital mortality similar to the older group of nonsmokers.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | MYOCARDIAL-INFARCTION; CARDIOVASCULAR-DISEASE; SMOKING-CESSATION; CARDIAC SOCIETY; 52 COUNTRIES; RISK; INTERHEART; MORTALITY; CRITERIA; OUTCOMES; Acute coronary syndrome; Chest pain unit; Smoking; Coronary artery disease; ST-elevation myocardial infarction |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Innere Medizin II |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 26 Mar 2021 07:48 |
| Last Modified: | 26 Mar 2021 07:48 |
| URI: | https://pred.uni-regensburg.de/id/eprint/44658 |
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