AI Article Synopsis
- Smoking cigarettes leads to elevated carbon monoxide (CO) levels in the blood, which can reduce oxygen capacity and potentially worsen outcomes for smokers experiencing acute cardiac events.
- A study of 1,379 patients in France found that 27% were active smokers and those with CO levels above 11 parts per million (ppm) had a significantly higher risk of death and major adverse cardiac events (MAE).
- Elevated CO levels were shown to be independently linked to a 6-fold increase in one-year mortality and a 10-fold increase in in-hospital MAE among smokers, regardless of other health factors.
Article Abstract
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 < 0.001). Similar results were found after adjustment for comorbidities (hazard ratio [HR] [95% confidence interval (CI)]): 5.92 [2.43-14.38]) or parameters of in-hospital severity (HR 6.09, 95% CI [2.51-14.80]) and propensity score matching (HR 7.46, 95% CI [1.70-32.8]). CO > 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.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10796965 | PMC |
| http://dx.doi.org/10.1016/j.eclinm.2023.102401 | DOI Listing |
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