4 years ago

Tobacco Exposure as Determined by Serum Cotinine and Subclinical Myocardial Injury in Individuals Free from Cardiovascular Disease

Tobacco exposure including second-hand smoke is the leading preventable cause of premature death in the United States. Serum cotinine, a highly sensitive and specific biomarker for tobacco exposure, is a more accurate measure of tobacco exposure than self-reported smoking status. Although the harmful effect of tobacco exposure on cardiovascular disease (CVD) risk factors (e.g., atherosclerosis) or hard CVD outcomes (e.g., myocardial infarction) is well established, its effect on intermediate outcomes such as subclinical myocardial injury (SMI), especially in nonsmokers, is not clear. Therefore, we examined the risk of SMI, defined as a Cardiac Infarction/Injury Score of ≥10 points on the 12-lead electrocardiogram with abnormal serum cotinine levels (>15 ng/ml) in 6,264 smokers and nonsmokers who were free from CVD enrolled in the Third National Health and Nutrition Examination Survey. SMI was more common in those with abnormal compared with normal serum cotinine levels (25.9% vs 19.6%, respectively; p <0.01). In a multivariable logistic regression model adjusted for age, gender, race, obesity, diabetes, hypertension, and dyslipidemia, abnormal (vs normal) serum cotinine was associated with a 61% increased risk of SMI (odds ratio 1.61, 95% confidence interval 1.40 to 1.85, p <0.01). This association was stronger in smokers, in women, and in nondiabetic and nonobese participants. In conclusion, elevated serum cotinine levels are associated with an increased risk of SMI in participants free from CVD, and this association is stronger in certain groups of participants. These findings underscore the harmful effect of both active and passive tobacco exposures on the cardiovascular system, and highlight the need for a personalized risk assessment that takes into account groups at high risk.

Publisher URL: www.sciencedirect.com/science

DOI: S0002914917311128

You might also like
Discover & Discuss Important Research

Keeping up-to-date with research can feel impossible, with papers being published faster than you'll ever be able to read them. That's where Researcher comes in: we're simplifying discovery and making important discussions happen. With over 19,000 sources, including peer-reviewed journals, preprints, blogs, universities, podcasts and Live events across 10 research areas, you'll never miss what's important to you. It's like social media, but better. Oh, and we should mention - it's free.

  • Download from Google Play
  • Download from App Store
  • Download from AppInChina

Researcher displays publicly available abstracts and doesn’t host any full article content. If the content is open access, we will direct clicks from the abstracts to the publisher website and display the PDF copy on our platform. Clicks to view the full text will be directed to the publisher website, where only users with subscriptions or access through their institution are able to view the full article.