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Life-years gained by smoking cessation after PCI

In patients with coronary heart disease who underwent percutaneous coronary intervention (PCI) in the late 1980s, smoking cessation resulted in at least 2.1 life-years gained, according to a study1 published recently in the American Journal of Cardiology.

The study, aiming to describe the effect of smoking cessation in terms of prolonged life-years gained, sampled 856 patients who underwent PCI during 1980 to 1985. Patients were followed up for 30 years and smoking status at one year could be retrieved in 806 patients.

The 27 patients who died within one year were excluded from the analysis. The median follow-up was 19.5 years (interquartile range 6.0 to 23.0). Cumulative 30-year survival rate was 29% in the group of patients who quit smoking and 14% in persistent smokers (p = 0.005).

After adjustment for baseline characteristics at the time of PCI, smoking cessation remained an independent predictor of lesser mortality (adjusted hazard ratio 0.57, 95% confidence interval 0.46 to 0.71). The estimated life expectancy was 18.5 years in those who quit smoking and 16.4 years in the persistent smokers (p <0.0001).

Editors’ note

In view of these important findings from a large sample of US patients undergoing PCI, we would be very interested in comments from UK interventional and other cardiologists. Questions we might address include:

  • Do we routinely offer advice on smoking cessation to all PCI patients?
  • Do we adequately promote smoking cessation clinics to all cardiovascular patients?
  • Do we audit smoking habit, quit rates, and outcomes among patients who have had a coronary angioplasty?

These are topics that we hope to return to in future editions of BJC Arrhythmia Watch.

References

1. de Boer S, Serruys P, Valstar G, et al. Life-Years Gained by Smoking Cessation After Percutaneous Coronary Intervention. Am J Cardiol 2013. http://dx.doi.org/10.1016/j.amjcard.2013.05.075

Published on: August 30, 2013

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