Combined effects of smoking and peripheral arterial disease on all-cause and cardiovascular disease mortality in a Chinese male cohort

Luo, Yingyi; Li, Xiankai; Li, Jue; Wang, Xiaoming; Qiao, Yongxia; Hu, Dayi; Merriam, Philip A.; Ma, Yunsheng

doi:10.1016/j.jvs.2009.09.024

« Previous Next »Journal of Vascular Surgery
Volume 51, Issue 3 , Pages 673-678, March 2010

Combined effects of smoking and peripheral arterial disease on all-cause and cardiovascular disease mortality in a Chinese male cohort

Yingyi Luo, MD
- Shanghai Institute of Health Sciences, Shanghai, China
- Heart, Lung, and Blood Vessel Center, Tongji University School of Medicines, Shanghai, China
Xiankai Li, MD
- Heart, Lung, and Blood Vessel Center, Tongji University School of Medicines, Shanghai, China
Jue Li, MD, PhD
- Heart, Lung, and Blood Vessel Center, Tongji University School of Medicines, Shanghai, China
- Reprint requests: Jue Li, MD, PhD, Tongji University School of Medicine, Heart, Lung, and Blood Vessel Research Center, 1239 Siping Road, Shanghai 200092, China
Xiaoming Wang, MD
- Shanghai Institute of Health Sciences, Shanghai, China
Yongxia Qiao, MD
- Heart, Lung, and Blood Vessel Center, Tongji University School of Medicines, Shanghai, China
Dayi Hu, MD
- Heart, Lung, and Blood Vessel Center, Tongji University School of Medicines, Shanghai, China
Philip A. Merriam, MSPH
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Mass
Yunsheng Ma, MD, PhD
- Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, Mass

Received 16 July 2009; accepted 12 September 2009.

Objective

Smoking is a major risk factor for peripheral arterial disease (PAD), and PAD is associated with all-cause and cardiovascular disease (CVD) mortality. The objective of this study was to determine the combined effects of smoking and PAD on all-cause and CVD mortality.

Methods

A total of 1979 males 35 years of age or older were enrolled from eight university-affiliated hospitals in Beijing and Shanghai in 2004, with both smoking status and PAD diagnosis obtained, 1712 of them had complete follow-up data. Mortality data were obtained from all participants between December 2007 and February 2008. Cox proportional hazards models were used to evaluate relative risks (RRs) of all-cause mortality and CVD mortality among different groups.

Results

At baseline, the average age of participants was 66.98-years-old (SD = 11.57), prevalence of PAD was 24.0% and 65.4% smoked cigarettes. During the 3-year follow-up, all-cause cumulative mortality rates were 27.9% (PAD/smoker), 26.3% (PAD/nonsmoker), 14.1% (no PAD/smoker), and 14.4% (no PAD/nonsmoker) (P < .001), and CVD cumulative mortality rates were 17.8%, 14.9%, 8.1%, and 7.3%, respectively (P < .001). Compared with the no PAD/nonsmoker subjects, adjusted RR from all-cause mortality in the groups of both PAD/smoker, PAD/nonsmoker, and no PAD/smoker were 1.88 (95% confidence interval [CI], 1.34-2.64), 1.37 (95% CI, 0.85-2.23), and 1.08 (95% CI, 0.79-1.49), respectively. The adjusted RR from CVD mortality was 2.12 (95% CI, 1.37-3.28), 1.55 (95% CI, 0.84-2.86), and 1.13 (95% CI, 0.74-1.71), respectively.

Conclusion

PAD is a major determinant of mortality. Smoking did not contribute to mortality in this study. Further research is needed.

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Competition of interest: none.

The editors and reviewers of this article have no relevant financial relationships to disclose per the JVS policy that requires reviewers to decline review of any manuscript for which they may have a competition of interest.

PII: S0741-5214(09)01910-7

doi:10.1016/j.jvs.2009.09.024