학술논문
Carbon monoxide and prognosis in smokers hospitalised with acute cardiac events: a multicentre, prospective cohort studyResearch in context
Document Type
article
Author
Jean-Guillaume Dillinger; Théo Pezel; Clément Delmas; Guillaume Schurtz; Antonin Trimaille; Nicolas Piliero; Claire Bouleti; Benoit Lattuca; Stéphane Andrieu; Julien Fabre; Reza Rossanaly Vasram; Jean-Claude Dib; Victor Aboyans; Charles Fauvel; Francois Roubille; Edouard Gerbaud; Albert Boccara; Etienne Puymirat; Solenn Toupin; Eric Vicaut; Patrick Henry; Emeric Albert; Franck Albert; Sean Alvain; Nabil Amri; Sabir Attou; Simon Auvray; Sonia Azzakani; Ruben Azencot; Marc Bedossa; Franck Boccara; Thomas Bochaton; Eric Bonnefoy-Cudraz; Guillaume Bonnet; Nabil Bouali; Océane Bouchot; Tanissia Boukertouta; Jean-Baptiste Brette; Marjorie Canu; Aures Chaib; Clement Charbonnel; Anne-Solene Chaussade; Alexandre Coppens; Yves Cottin; Arthur Darmon; Elena de Angelis; Laura Delsarte; Antoine Deney; Clemence Docq; Valentin Dupasquier; Meyer Elbaz; Antony El Hadad; Amine El Ouahidi; Nacim Ezzouhairi; Damien Fard; Édouard Gerbaud; Martine Gilard; Marc Goralski; Nissim Grinberg; Alain Grentzinger; Marie Hauguel-Moreau; Fabien Huet; Thomas Landemaine; Léo Lemarchand; Thomas Levasseur; Pascal Lim; Laura Maitre Ballesteros; Nicolas Mansencal; Benjamin Marie; David Martinez; Benoit Merat; Christophe Meune; Damien Millischer; Thomas Moine; Pascal Nhan; Nathalie Noirclerc; Patrick Ohlmann; Fabien Picard; Thibaut Pommier; Arthur Ramonatxo; François Roubille; Vincent Roule; Mathilde Stevenard; David Sulman; Fédérico Swedsky; Victoria Tea; Eugénie Thevenet; Christophe Thuaire; Christophe Tron; Guillaume Viboud; Dominique Yomi; Cyril Zakine
Source
EClinicalMedicine, Vol 67, Iss , Pp 102401- (2024)
Subject
Language
English
ISSN
2589-5370
Abstract
Summary: Background: Smoking cigarettes produces carbon monoxide (CO), which can reduce the oxygen-carrying capacity of the blood. We aimed to determine whether elevated expiratory CO levels would be associated with a worse prognosis in smokers presenting with acute cardiac events. Methods: From 7 to 22 April 2021, expiratory CO levels were measured in a prospective registry including all consecutive patients admitted for acute cardiac event in 39 centres throughout France. The primary outcome was 1-year all-cause death. Initial in-hospital major adverse cardiac events (MAE; death, resuscitated cardiac arrest and cardiogenic shock) were also analysed. The study was registered at ClinicalTrials.gov (NCT05063097). Findings: Among 1379 patients (63 ± 15 years, 70% men), 368 (27%) were active smokers. Expiratory CO levels were significantly raised in active smokers compared to non-smokers. A CO level >11 parts per million (ppm) found in 94 (25.5%) smokers was associated with a significant increase in death (14.9% for CO > 11 ppm vs. 2.9% for CO ≤ 11 ppm; p 11 ppm was associated with a significant increase in MAE in smokers during initial hospitalisation after adjustment for comorbidities (odds ratio [OR] 15.75, 95% CI [5.56–44.60]) or parameters of in-hospital severity (OR 10.67, 95% CI [4.06–28.04]). In the overall population, CO > 11 ppm but not smoking was associated with an increased rate of all-cause death (HR 4.03, 95% CI [2.33–6.98] and 1.66 [0.96–2.85] respectively). Interpretation: Elevated CO level is independently associated with a 6-fold increase in 1-year death and 10-fold in-hospital MAE in smokers hospitalized for acute cardiac events. Funding: Grant from Fondation Coeur & Recherche.