Quitting smoking yields CV benefit equivalent of three medications
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The estimated lifetime treatment benefit of smoking cessation was comparable to the use of several pharmaceutical treatments combined, even when the analysis was limited to major CV events, researchers reported.
New risk prediction models estimate and employ individual treatment benefit; however, models are usually calculated for a limited set of CV outcomes like MI or stroke, Tinka J. van Trier, MD, a doctoral student at Amsterdam University Medical Centre, and colleagues wrote in an abstract presented at presented at ESC Preventive Cardiology 2022, a scientific congress of the European Society of Cardiology. By disregarding non-CV outcomes, the overall benefit of smoking cessation will be underestimated, the researchers wrote in an abstract.
“We were concerned that the benefits of smoking cessation would be overlooked due to the increasing number of pharmaceutical options for secondary prevention,” Van Trier told Healio. “Smoking cessation remains one of the most important preventive measures to improve the overall health of coronary patients.”
In a meta-analysis, van Trier and colleagues analyzed pooled, individual-level risk factors data from six large prospective studies: RESPONSE 1 and 2, OPTICARE, EUROASPIRE IV and V and HELIUS (n = 989; 23% women; mean age, 60 years). Studies included participants aged at least 45 years who persisted in smoking at least 6 months after ACS or revascularization (median, 1.2 years after index event).
The researchers estimated and compared treatment benefits — expressed as gain in years without major CV events — of smoking cessation vs. persistent smoking plus the use of one or more targeted drugs: bempedoic acid (Nexletol, Esperion Therapeutics), colchicine and PCSK9 inhibitors.
The primary outcome was SMART-REACH estimated treatment benefit, expressed as gain in years without a MI or stroke.
Researchers found that smoking cessation was associated with a 4.81-year gain in event-free years (95% CI, 4.73-4.89), whereas persistent smoking with maximal pharmaceutical treatment resulted in a comparable gain of 4.83 event-free years (95% CI, 4.72-4.93).
The researchers noted the substantial health benefit underscores smoking cessation as one of the most important actions to improve the overall health of patients with established atherosclerotic CVD.
“This indicates that smoking cessation is a very important step toward adding healthy years to one’s lifetime,” van Trier said in an ESC press release. “It is important to remember that the analysis did not even account for the other advantages of giving up the habit — for example on respiratory illnesses, cancer and longevity.”
Van Trier called smoking cessation a cornerstone of preventing MIs and strokes and improving overall health at any time.
“Hopefully, these results reemphasize the importance of smoking cessation in combination with the use of preventive drugs,” Van Trier told Healio.
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van Trier TJ, et al. Moderated posters session 1 – secondary prevention and rehabilitation. Presented at: ESC Preventive Cardiology; April 7-9, 2022 (virtual meeting).
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