Quitting smoking beneficial after PCI

Patients are at raised risk of adverse outcomes if they continue to smoke after percutaneous coronary intervention, researchers warn today.

Professor Jung-Kyu Han of Seoul National University Hospital, South Korea, and colleagues investigated the impact of smoking and stopping smoking on this patient group.

They used figures from a nationwide Korean database including 74,471 people who underwent PCI from 2009 to 2016.

The risk of a “major adverse cardiovascular and cerebrovascular event”, covering all-cause death, heart attack, coronary revascularisation, and stroke, over the subsequent four years was calculated.

Analysis showed that current smokers had a 20% higher chance of these outcomes than non-smokers. However, ex-smokers had a similar rate to nonsmokers.

A smaller group of 31,887 patients had pre- and post-PCI health check-up information.

This indicated that the risk for those who had been smoking for 20 or more years but stopped after PCI, was similar to those who kept smoking.

But for those who had smoked for less than 20 years and stopped, the risk fell to that of long term non-smokers.

In the European Heart Journal today, the authors write: “Quitting smoking after PCI was associated with a reduction in major adverse cardiovascular and cerebrovascular event, but only in patients with a cumulative exposure of less than 20 years.

“Smoking cessation is a fundamental measure for better clinical outcomes in patients undergoing PCI.”

Professor Han said: “From the beginning of this study, my colleagues and I, as clinical researchers, suspected that there could be a threshold for irreversible harm resulting from smoking.

“Patients undergoing percutaneous coronary intervention should be encouraged to quit smoking as soon as possible, and smoking cessation may improve their cardiovascular outcomes even within a relatively short period of time.”

Ki, Y-J. et al. Smoking and cardiovascular outcomes after percutaneous coronary intervention: a Korean study. European Heart Journal 27 September 2023 doi: 10.1093/eurheartj/ehad616


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