History of Cigarette Smoking and Heart Transplant Outcomes

Abstract

Objective: The deleterious effects of cigarette smoking (CS) have been well documented. Active cigarette use is a relative contraindication for heart transplantation (HT) with a recommendation that candidates be abstinent for at least 6 months prior to HT. Animal studies have shown that a history of CS is associated with increased risk of allograft rejection. Our study examines the association of CS history and HT outcomes. Methods: Data were analyzed from HT recipients captured in the United Network for Organ Sharing (UNOS) transplant registry. Included in this study were adults who underwent HT from 1987 to 2018 and who had available smoking status data (N= 38,220). The cohort was categorized by smoking status (CS vs non-CS). Post-transplant outcomes of interest included survival, graft failure, treated hospitalizations and hospitalizations for infection. Baseline characteristics were compared between the two groups using chi-squared analysis. Unadjusted associations between CS and patient survival were determined using Kaplan-Meier estimations and confounding was addressed using multivariable Cox proportional hazards models. Results: HT recipients with a history of CS were older (55 vs 50, p= <0.0001), more likely to be Caucasian (75.7 vs 62.3, p= <0.0001), Male (81.7 vs 68.2, p=<0.

Statistical Bioinformatics to Uncover the Underlying Biological Mechanisms That Linked Smoking with Type 2 Diabetes Patients Using Transcritpomic and GWAS Analysis

“…T2D development is significantly influenced by the MAPK signalling pathway [ 74 ], where cigarette smoke particles may activate MAPK pathways [ 75 ]. The Allograft Rejection pathway is also activated in T2D patients [ 76 ], where Allograft Rejection is more likely to active in people with a history of smoking cigarettes [ 77 , 78 ]. PI3K/AKT pathway damaged in various tissues of the body leads to the development of T2D as the result of insulin resistance [ 79 ], and tobacco smoke exposure can activate PI3K/Akt pathway [ 80 ].…”