Switching to E-Cigarettes or Quitting Reduces Cardiac Risks After PCI
Researchers have found that patients with coronary artery disease (CAD) who had transitioned entirely to e-cigarettes or quit smoking altogether after percutaneous coronary intervention (PCI) had fewer major adverse cardiac events (MACE) compared to those who continued smoking combustible cigarettes. A recent study was conducted by Danbee Kang and colleagues which was published in the European Heart Journal.
Smoking is a major modifiable risk factor for cardiovascular disease, including coronary artery disease. Quitting smoking has been shown to improve the outcome, but how E-cigarettes serve as an alternative remains unclear. In this study, researchers examined whether switching to E-cigarettes has an impact on post-PCI outcomes, specifically on the risk of MACE.
Grouping from the Korean National Health Insurance database, 17,973 adult smokers (≥20 years) who underwent PCI and had completed health screens within 3 years before and after PCI. Participants were categorized into three groups:
Continued combustible cigarette users (49.8%, n=8,951).
Switchers to E-cigarettes (9.4%, n=1,694).
Subdivided into dual users and exclusive E-cigarette users.
Successful quitters (40.7%, n=7,328).
MACE incidence:
Continued combustible cigarette smokers: 17%.
E-cigarette switchers: 10%.
Successful quitters: 13.4%.
Adjusted hazard ratios for MACE:
E-cigarette switchers: 0.82 (95% CI: 0.69–0.98).
Successful quitters: 0.87 (95% CI: 0.79–0.96).
Dual users compared with exclusive E-cigarette users:
Exclusive e-cigarette use was strongly associated with reduced risk of MACE compared with dual use (HR: 0.71; 95% CI: 0.51-0.99).
Among smokers with PCI for CAD, smoking cessation and switching to e-cigarettes were both associated with less risk for MACE. These results show that smoking treatments which may improve the outcome in patients after PCI are necessary.
Reference:
Kang, D., Choi, K. H., Kim, H., Park, H., Heo, J., Park, T. K., Lee, J. M., Cho, J., Yang, J. H., Hahn, J.-Y., Choi, S.-H., Gwon, H.-C., & Song, Y. B. (2024). Prognosis after switching to electronic cigarettes following percutaneous coronary intervention: a Korean nationwide study. European Heart Journal. https://doi.org/10.1093/eurheartj/ehae705
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