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Assessment of serum cotinine in patients with chronic heart failure: self-reported versus objective smoking behaviour

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Abstract

Background

Smoking is a major risk factor in the development of coronary artery disease and thus chronic heart failure (HF). The value of self-reported smoking behaviour has not been validated in patients with HF. We sought to assess serum cotinine levels, a marker of recent tobacco exposure, in a cohort of clinically stable patients with chronic HF.

Methods and results

We analysed serum cotinine values in 75 patients with chronic HF [mean age ± SD 64 ± 16 years, 85 % male, left ventricular ejection fraction 30 ± 1 %, New York Heart Association class (I/II vs. III/IV) 73 %/27 %, haemoglobin (Hb) 13.4 ± 1.5 g/dL, serum creatinine 1.21 ± 0.51 mg/dL] and 30 control subjects of similar age (63 ± 11 years, 43 % male, Hb 14.1 ± 1.5 g/dL, creatinine 1.12 ± 0.92 mg/dL) using a chemiluminescence immunoassay. Patients were interviewed about their smoking habits, and routine laboratory parameters were analysed. In patients with HF, cotinine values ranged from undetectable to 829 μg/L (mean 110 ± 208 μg/L). Similar findings were evident in healthy subjects with cotinine ranging from undetectable to 860 μg/L (mean 105 ± 208 μg/L). Serum cotinine levels correlated with leukocyte count and haemoglobin concentration (both p < 0.05). Self-reported smoking behaviour did not correspond to serum cotinine level in serum in 16.9 % of the patients with chronic HF. No such finding was evident in control subjects.

Conclusions

Serum cotinine measurement provides an easily applicable means to analyse smoking behaviour in patients with chronic HF. Its assessment may permit analysis of smoking deception in daily clinical routine.

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Acknowledgments

Part of this work has received funding from the European Union Seventh Framework Programme (FP7/2007-2013) under Grant Agreement No. 241558 (SICA-HF).

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Authors and Affiliations

  1. Department of Cardiology, Applied Cachexia Research, Charité Medical School, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany

    Nicole Ebner, Tibor Szabo, Matthias Tacke, Susann Fülster, Anja Sandek, Wolfram Doehner, Stefan D. Anker & Stephan von Haehling

  2. Department of Clinical Cardiology, National Heart and Lung Institute, Imperial College, London, UK

    Gabor Földes

  3. Center for Stroke Research Berlin, Charité Medical School, Berlin, Germany

    Wolfram Doehner

  4. Centre for Clinical and Basic Research, IRCCS San Raffaele, Rome, Italy

    Stefan D. Anker

  5. Center for Cardiovascular Research (CCR), Charité Medical School, Campus Mitte, Berlin, Germany

    Stephan von Haehling

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  1. Nicole Ebner
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Correspondence to Stephan von Haehling.

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Ebner, N., Földes, G., Szabo, T. et al. Assessment of serum cotinine in patients with chronic heart failure: self-reported versus objective smoking behaviour. Clin Res Cardiol 102, 95–101 (2013). https://doi.org/10.1007/s00392-012-0499-0

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  • DOI: https://doi.org/10.1007/s00392-012-0499-0

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