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![Page 1: A multifactorial smoking cessation programme for patients with coronary artery disease: experiences and preliminary results. Pedersen et al. Nerth Heart.](https://reader033.fdocuments.us/reader033/viewer/2022051223/570638651a28abb823901f85/html5/thumbnails/1.jpg)
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A multifactorial smoking cessation programme for patients with coronary artery disease: experiences and preliminary results. Pedersen et al. Nerth Heart Jour, Vol 10, N 2, Feb 2002
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Tabagismo: Papel na patogênese dos Tabagismo: Papel na patogênese dos Eventos CardiovascularesEventos Cardiovasculares
Disfunção EndotelialDisfunção Endotelial Trombogenicidade Trombogenicidade
hematológica aumentadahematológica aumentada Aumento da resposta Aumento da resposta
inflamatóriainflamatória Modificação OxidativaModificação Oxidativa
Lavi et al. Circulation. 2007;115:2621-2627; http://www.texasheartinstitute.org/HIC/Topics/Diag/diangio.cfm. Accessed June 14, 2007.
Doença Aterosclerótica Artéria Coronarária
Direita
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Tabagismo: Disfunção Endotelial EpicárdicaTabagismo: Disfunção Endotelial Epicárdica
Lavi et al. Circulation. 2007;115:2621-2627.
Fumantes apresentam maior probabilidade de ter disfunção endotelial Fumantes apresentam maior probabilidade de ter disfunção endotelial epicárdica comparados a não fumantes.epicárdica comparados a não fumantes.
Dis
funç
ão E
ndot
elia
l (%
) P=.0360
45
30
15
0Não -fumantes Ex-fumantes Fumantes
46%
34%35%
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Tabagismo: Biosíntese reduzida de Tabagismo: Biosíntese reduzida de Óxido Nítrico (NO)Óxido Nítrico (NO)
Barua et al. Circulation. 2001;104:1905-1910.
5000
0Não-fumantes Fumantes
4000
3000
2000
1000
Con
cent
raçã
o N
O (n
mol
/L) P<.0001
1266
3613
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Tabagismo: Fator de Risco Multiplicativo Tabagismo: Fator de Risco Multiplicativo para Doença Arterial Coronáriapara Doença Arterial Coronária
a All rates were age-adjusted by 10-year age groups to the US white male population in 1980. Hypercholesterolemia defined as cholesterol 250 mg/dL. Hypertension defined as a diastolic blood pressure 90 mm Hg. Burns. Prog Cardiovasc Dis. 2003;46(1): 11-29; Source: Pooling Project Research Group, 1978.
Tabagismo +Colesterol elevado
ou Hipertensão
Colesterolelevado +
Hipertensão
Todos 3 Fatores Risco Presentes
Tabagismo, ColesterolElevado, ou Hipertensão
isolada
Sem fatorde Risco
Taxa
s po
r 10
00a
23
54
10392
189
0
50
100
150
200
250
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Tabagismo: Efeito sobre a DACTabagismo: Efeito sobre a DAC
Waters et al. Circulation. 1996;94:614-621.
0
10
20
30
40
50
60
Progressão de Lesões Existentes
Paci
ente
s (%
)
FumantesNão-fumantes0
10
20
30
40
50
60
Formação de Novas Lesões
Paci
ente
s (%
)
FumantesNão-fumantes
P=.002 P=.007
5757
3737 3636
2020
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Tabagismo: Risco aumentado de IAM com Tabagismo: Risco aumentado de IAM com onda Q, após angioplastiaonda Q, após angioplastia
aThe probability of an event (developing a disease) occurring in exposed people compared with the probability of the event in nonexposed people. Adjusted for the baseline variables significantly associated with each end point.Hasdai et al. N Engl J Med. 1997;336:755-761.
0.0
1.0
2.0
3.0
4.0
Nonsmokers Ex-smokers Current Smokers
Infarto do Miocárdio com onda Q
Ris
co R
elat
ivo
(95%
IC)a
1.01.01.281.28
2.082.08
Não fumantes Ex- fumantes Fumantes
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Tabagismo é importante fator de risco para DAC via:Tabagismo é importante fator de risco para DAC via:– Disfunção EndotelialDisfunção Endotelial– Aumento da trombogenicidadeAumento da trombogenicidade– LeucocitoseLeucocitose– Aumento do estresse oxidativoAumento do estresse oxidativo– Redução da biosíntese do NORedução da biosíntese do NO
Tabagismo atua como fator de risco multiplicativo no Tabagismo atua como fator de risco multiplicativo no desenvolvimento da DACdesenvolvimento da DAC
Tabagismo está associado com o desenvolvimentoTabagismo está associado com o desenvolvimento– Taxa de pregoressão de DACTaxa de pregoressão de DAC– Risco de anginaRisco de angina– Risco de de IAMRisco de de IAM– Risco de morte súbita de origem cardíacaRisco de morte súbita de origem cardíaca– Risco de de Infarto com onda Q após angioplastiaRisco de de Infarto com onda Q após angioplastia
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Smoking Cessation Interventions for Hospitalized Smokers A Systematic Review. Rigotti et al. Arch Intern Med. 2008;168(18):1950-1960
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Smoking Cessation Interventions for Hospitalized Smokers A Systematic Review. Rigotti et al. Arch Intern Med. 2008;168(18):1950-1960
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Smoking Cessation Interventions for Hospitalized Smokers A Systematic Review. Rigotti et al. Arch Intern Med. 2008;168(18):1950-1960
![Page 14: A multifactorial smoking cessation programme for patients with coronary artery disease: experiences and preliminary results. Pedersen et al. Nerth Heart.](https://reader033.fdocuments.us/reader033/viewer/2022051223/570638651a28abb823901f85/html5/thumbnails/14.jpg)
Smoking Cessation Interventions for Hospitalized Smokers A Systematic Review. Rigotti et al. Arch Intern Med. 2008;168(18):1950-1960
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Smoking Cessation Interventions for Hospitalized Smokers A Systematic Review. Rigotti et al. Arch Intern Med. 2008;168(18):1950-1960
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Treating Tobacco Use and Dependence: 2008 Update. Fiori et al. U.S. Department of Health and Human Services Public Health Service May 2008
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Pesquisas em andamento com uso da vareniclina em pacientes com DAC
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Pesquisas em andamento com uso da vareniclina em pacientes com DAC
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