Abstract 9859: Secondhand Smoke Exposure is Associated with Abnormal P-Wave Axis

Abstract

Introduction: Secondhand smoke exposure (SHSE) is associated with increased risk of cerebrovascular accident (CVA). Abnormal p-wave axis (aPWA) is a marker for atrial disease that is also associated with CVA risk. Hypothesis: SHSE is independently associated with aPWA. Methods: This analysis included 5,986 nonsmokers (age 61.7±13.8, 45.8% men, 77.4% whites) from the Third National Health and Nutrition Examination Survey. SHSE was defined as serum cotinine ≥1ng/mL. Serum cotinine cut-points of ≥3ng/mL and ≥6ng/mL were used to assess dose-response. Multivariable logistic regression was used to examine the association between SHSE and aPWA. The consistency of this association was tested among subgroups stratified by demographics and comorbidities. Results: About 18.5% (n=1109) of the participants had SHSE. After adjusting for demographic and comorbid covariates, SHSE was associated with a 28% increased odds of aPWA (p-value=0.003). Serum cotinine cut-points of ≥3ng/mL and ≥6ng/mL were associated with 35% increased odds of aPWA (p-value=0.002) and 38% increased odds of aPWA (p-value=0.002), respectively. This association was stronger among those of white ethnicity [Odds Ratio (95% Confidence Interval): 1.36 (1.12-1.66), interaction p-value=0.04]. Conclusions: SHSE is associated with aPWA with possible effect modification by ethnicity. This is a novel finding that further underscores the harmful effects of SHSE on cardiovascular health and merits a personalized risk assessment when counseling patients on SHSE. Further prohibition of smoking in public areas should be emphasized, especially in regions with less-stringent public health policies.