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Smoking cessation may lower odds for recurrent CV events at any age
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Quitting smoking after an initial CV event led to reduced risk for recurrent vascular events and all-cause mortality regardless of age, according to findings published in the American Heart Journal.
The researchers wrote that smoking cessation was effective in reducing CV risk compared with pharmaceutical treatment of risk factors and should be an objective for patients with vascular disease.
M. Johanneke van den Berg, MD, and colleagues investigated the relation between smoking cessation after a first CV event and risk for recurrent CV events and mortality.
“Although presence of CV disease was not taken into account, the British Doctors Study and a more recent study based on the United States Health Interview Survey showed that cessation of smoking, even at the age of 60, was related to improved survival with an average gain of 3 years compared to patients who continued smoking,” van den Berg, a physician in the department of vascular medicine at the University Medical Center Utrecht and in the department of anesthesiology at Amsterdam UMC, Vrije Universiteit in the Netherlands, and colleagues wrote. “Insight and quantification of the potential gain in life-years would be helpful in stimulating doctors to better motivate patients to quit smoking, also after onset of CV disease.”
Data from 4,673 patients from the SMART study (mean age, 61 years; 75% men) with 1 year or less since their first manifestation of arterial disease were analyzed by the researchers.
The researchers found that one-third of smokers stopped after their initial CV event. During a median follow-up of 7.4 years, 17% of patients died and 15% had major atherosclerotic CV events, defined as stroke, MI or vascular mortality. When the definition of major atherosclerotic CV events was expanded to include vascular interventions, the rate was 35% during the study period.
Patients who quit smoking after their first major atherosclerotic CV event had lower risk for recurrent events (adjusted HR = 0.66; 95% CI, 0.49-0.88) and all-cause mortality (aHR = 0.63; 95% CI, 0.48-0.82) compared with patients who continued to smoke, van den Berg and colleagues wrote.
Patients who reported smoking cessation on average lived 5 life-years longer and had recurrent major atherosclerotic CV events occur 10 years later compared with patients who did not stop smoking, the researchers wrote.
Among patients with an initial CV event at age 70 years and older, the rate of survival was higher in the smoking cessation group compared with never or former smokers, van den Berg and colleagues wrote.
“Irrespective of age, cessation of smoking after a first CV event should be a key objective for both patients and physicians to lower the risk for recurrent vascular events,” van den Berg and colleagues wrote. – by Earl Holland Jr.
Disclosures: The authors report no relevant financial disclosures.
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