为什么需要帮助冠心病患者戒烟.pptVIP

为什么需要帮助冠心病患者戒烟？ 吸烟增加冠心病的发生和死亡风险！ 吸烟危害冠心病的机制 吸烟使冠心病的发生风险增加 吸烟加速既有冠心病的进展，并增加新损伤发生率 心绞痛的风险与吸烟量直接相关 吸烟增加心源性猝死的风险 冠心病死亡风险的增加与吸烟量直接相关 吸烟使冠脉介入治疗后发生心梗的风险增高 戒烟使冠心病患者受益！ 戒烟是冠心病强效干预措施 戒烟使心梗风险降低 戒烟使冠脉介入治疗后死亡率下降 戒烟使再发心脏骤停风险减低 为什么戒烟这么难？ 戒烟难，难在戒断症状难以忍受 戒烟难，还在于戒断后容易复发 戒烟能降低心梗发生的风险，从图可以看出，吸烟者发生急性心梗的比值比较高，而戒烟后受试者的急性心梗发生的比值比明显下降，并随着戒烟年数的增长其下降程度越大，说明戒烟能有效预防心梗的发生。 戒烟使心梗风险降低 Key Point Risk of acute MI associated with smoking is significantly reduced within a few years of quitting. Teo et al evaluated 12,461 cases of first acute MI and 14,637 age-matched and sex-matched controls in the international, multicenter INTERHEART study. Trained staff administered a questionnaire to both cases and controls in which participants were asked detailed questions about their smoking status. Risk of acute MI associated with smoking was markedly reduced within a few years of quitting. Risk of acute MI decreased progressively with time since becoming abstinent; however, some increased risk persisted, even in those who had quit more than 20 years prior. Reference Teo KK, Ounpuu S, Hawken S, et al, on behalf of the INTERHEART Study Investigators. Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study: a case-control study. Lancet. 2006;368:647-658. 此外，戒烟还能降低再发心脏骤停的风险。由图可知，吸烟者在三年内心脏骤停反复发作的发生率（27％）明显比戒烟者的（19％）高，p0.05，有显著性差异。说明戒烟能降低再发心脏骤停的风险。 Key Point Smoking cessation is associated with a significant reduction in risk of recurrent cardiac arrest. Hallstrom et al performed a life-table analysis of 310 survivors of out-of-hospital cardiac arrest who were current smokers at the time of the cardiac arrest to determine if immediate smoking cessation after hospitalization was associated with a decrease in risk of recurrent cardiac arrest. The life-table analysis included information about smoking cessation following hospital discharge, which was obtained through surveys of the families of the survivors and a review of medical records. Patients with coronary artery di