Smoking status and mortality outcomes following percutaneous coronary intervention

Sathish Parasuraman, Azfar G. Zaman, Mohaned Egred, Alan Bagnall, Paul Broadhurst, Javed Ahmed, Richard Edwards, Raj Das, Deepak Garg, Ian Purcell, Awsan Noman

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Abstract

Objective: The aim of this study was to assess the impact of smoking on short (30-day) and intermediate (30-day to 6-month) mortality following percutaneous coronary intervention (PCI). Background: The effect of smoking on mortality post-PCI is lacking in the modern PCI era. Methods: This was a retrospective analysis of prospectively collected data comparing short- and intermediate-term mortality amongst smokers, ex-smokers and non-smokers. Results: The study cohort consisted of 12,656 patients: never-smokers (n = 4288), ex-smokers (n = 4806) and current smokers (n = 3562). The mean age (±standard deviation) was 57 (±11) years in current smokers compared with 67 (±11) in ex-smokers and 67 (±12) in never-smokers; p < 0.0001. PCI was performed for acute coronary syndrome (ACS) in 84.1% of current smokers, 57% of ex-smokers and 62.9% in never-smokers; p < 0.0001. In a logistic regression model, the adjusted odds ratios (95% confidence intervals (CIs)) for 30-day mortality were 1.60 (1.10–2.32) in current smokers and 0.98 (0.70–1.38) in ex-smokers compared with never-smokers. In the Cox proportional hazard model, the adjusted hazard ratios (95% CI) for mortality between 30 days and 6 months were 1.03 (0.65–1.65) in current smokers and 1.19 (0.84–1.67) in ex-smokers compared with never-smokers. Conclusion: This large observational study of non-selected patients demonstrates that ex-smokers and never-smokers are of similar age at first presentation to PCI, and there is no short- or intermediate-term mortality difference between them following PCI. Current smokers undergo PCI at a younger age, more often for ACS, and have higher short-term mortality. These findings underscore the public message on the benefits of smoking cessation and the harmful effects of smoking.

Original languageEnglish
JournalEuropean Journal of Preventive Cardiology
Early online date3 Feb 2020
DOIs
Publication statusE-pub ahead of print - 3 Feb 2020

Keywords

  • Smoking, percutaneous coronary intervention, PCI outcome, smoking mortality, smoking and PCI, PCI mortality, smokers’ outcome, heart attack and smoking, stents in smokers
  • smokers' outcome
  • RISK-FACTORS
  • stents in smokers
  • smoking and PCI
  • smoking mortality
  • PCI mortality
  • DEATH
  • PCI outcome
  • heart attack and smoking
  • CESSATION
  • WOMEN
  • CIGARETTE-SMOKING
  • HEART-DISEASE
  • percutaneous coronary intervention
  • MEN
  • ACUTE MYOCARDIAL-INFARCTION
  • THROMBOLYTIC THERAPY
  • ARTERY-DISEASE
  • Smoking

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