Electrocardiographic Changes Associated with Smoking and Smoking Cessation: Outcomes from a Randomized Controlled TrialReportar como inadecuado




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Introduction

Cardiovascular disease CVD can be detected and quantified by analysis of the electrocardiogram ECG; however the effects of smoking and smoking cessation on the ECG have not been characterized.

Methods

Standard 12-lead ECGs were performed at baseline and 3 years after subjects enrolled in a prospective, randomized, placebo-controlled clinical trial of smoking cessation pharmacotherapies. ECGs were interpreted using the Minnesota Code ECG Classification. The effects of i smoking burden on the prevalence of ECG findings at baseline, and ii smoking and smoking cessation on ECG changes after 3 years were investigated by multivariable and multinomial regression analyses.

Results

At baseline, 532 smokers were mean SD 43.3 11.5 years old, smoked 20.6 7.9 cigarettes-day, with a smoking burden of 26.7 18.6 pack-years. Major and minor ECG criteria were identified in 87 16.4% and 131 24.6% of subjects, respectively. After adjusting for demographic data and known CVD risk factors, higher pack-years was associated with major ECG abnormalities p = 0.02, but current cigarettes-day p = 0.23 was not. After 3 years, 42.9% of subjects were abstinent from smoking. New major and minor ECG criteria were observed in 7.2% and 15.6% of subjects respectively, but in similar numbers of abstinent subjects and continuing smokers p>0.2 for both. Continuing smokers showed significant reduction in current smoking –8.4 8.8 cigarettes-day, p<0.001 compared to baseline.

Conclusions

In conclusion, major ECG abnormalities are independently associated with lifetime smoking burden. After 3 years, smoking cessation was not associated with a decrease in ECG abnormalities, although cigarettes smoked-day decreased among continuing smokers.



Autor: Adam D. Gepner, Megan E. Piper, Miguel A. Leal, Asha Asthana, Michael C. Fiore, Timothy B. Baker, James H. Stein

Fuente: http://plos.srce.hr/



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