TY - JOUR
T1 - Influence of cigarette smoking on ALS outcome
T2 - A population-based study
AU - Calvo, Andrea
AU - Canosa, Antonio
AU - Bertuzzo, Davide
AU - Cugnasco, Paolo
AU - Solero, Luca
AU - Clerico, Marinella
AU - De Mercanti, Stefania
AU - Bersano, Enrica
AU - Cammarosano, Stefania
AU - Ilardi, Antonio
AU - Manera, Umberto
AU - Moglia, Cristina
AU - Marinou, Kalliopi
AU - Bottacchi, Edo
AU - Pisano, Fabrizio
AU - Mora, Gabriele
AU - Mazzini, Letizia
AU - Chiò, Adriano
PY - 2016/11/1
Y1 - 2016/11/1
N2 - Objective To assess the prognostic influence of premorbid smoking habits and vascular risk profile on amyotrophic lateral sclerosis (ALS) phenotype and outcome in a population-based cohort of Italian patients. Methods A total of 650 patients with ALS from the Piemonte/Valle d'Aosta Register for ALS, incident in the 2007-2011 period, were recruited. Information about premorbid cigarette smoking habits and chronic obstructive pulmonary disease (COPD) were collected at the time of diagnosis. Results Current smokers had a significantly shorter median survival (1.9â €..years, IQR 1.2-3.4) compared with former (2.3â €..years, IQR 1.5-4.2) and never smokers (2.7â €..years, IQR 1.8-4.6) (p=0.001). Also COPD adversely influenced patients' prognosis. Both smoking habits and CODP were retained in Cox multivariable model. Conclusions This study has demonstrated in a large population-based cohort of patients with ALS that cigarette smoking is an independent negative prognostic factor for survival, with a dose-response gradient. Its effect is not related to the presence of COPD or to respiratory status at time of diagnosis. The understanding of the mechanisms, either genetic or epigenetic, through which exogenous factors influence disease phenotype is of major importance towards a more focused approach to cure ALS.
AB - Objective To assess the prognostic influence of premorbid smoking habits and vascular risk profile on amyotrophic lateral sclerosis (ALS) phenotype and outcome in a population-based cohort of Italian patients. Methods A total of 650 patients with ALS from the Piemonte/Valle d'Aosta Register for ALS, incident in the 2007-2011 period, were recruited. Information about premorbid cigarette smoking habits and chronic obstructive pulmonary disease (COPD) were collected at the time of diagnosis. Results Current smokers had a significantly shorter median survival (1.9â €..years, IQR 1.2-3.4) compared with former (2.3â €..years, IQR 1.5-4.2) and never smokers (2.7â €..years, IQR 1.8-4.6) (p=0.001). Also COPD adversely influenced patients' prognosis. Both smoking habits and CODP were retained in Cox multivariable model. Conclusions This study has demonstrated in a large population-based cohort of patients with ALS that cigarette smoking is an independent negative prognostic factor for survival, with a dose-response gradient. Its effect is not related to the presence of COPD or to respiratory status at time of diagnosis. The understanding of the mechanisms, either genetic or epigenetic, through which exogenous factors influence disease phenotype is of major importance towards a more focused approach to cure ALS.
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U2 - 10.1136/jnnp-2016-313793
DO - 10.1136/jnnp-2016-313793
M3 - Article
AN - SCOPUS:84988592854
VL - 87
SP - 1229
EP - 1233
JO - Journal of Neurology, Neurosurgery and Psychiatry
JF - Journal of Neurology, Neurosurgery and Psychiatry
SN - 0022-3050
IS - 11
ER -