Medical Dialogues
  • Dermatology
Login Register
This site is intended for healthcare professionals only
Login Register
  • MD Brand Connect
  • Vaccine Hub
  • MDTV
    • Breaking News
    • Medical News Today
    • Health News Today
    • Latest
    • Journal Club
    • Medico Legal Update
    • Latest Webinars
    • MD Shorts
    • Health Dialogues
  • Fact Check
  • Health Dialogues
Medical Dialogues
  • Medical News & Guidelines
      • Anesthesiology
      • Cardiology and CTVS
      • Critical Care
      • Dentistry
      • Dermatology
      • Diabetes and Endocrinology
      • ENT
      • Gastroenterology
      • Medicine
      • Nephrology
      • Neurology
      • Obstretics-Gynaecology
      • Oncology
      • Ophthalmology
      • Orthopaedics
      • Pediatrics-Neonatology
      • Psychiatry
      • Pulmonology
      • Radiology
      • Surgery
      • Urology
      • Laboratory Medicine
      • Diet
      • Nursing
      • Paramedical
      • Physiotherapy
  • Health news
      • Doctor News
      • Government Policies
      • Hospital & Diagnostics
      • International Health News
      • Medical Organization News
      • Medico Legal News
      • NBE News
      • NMC News
  • Fact Check
      • Bone Health Fact Check
      • Brain Health Fact Check
      • Cancer Related Fact Check
      • Child Care Fact Check
      • Dental and oral health fact check
      • Diabetes and metabolic health fact check
      • Diet and Nutrition Fact Check
      • Eye and ENT Care Fact Check
      • Fitness fact check
      • Gut health fact check
      • Heart health fact check
      • Kidney health fact check
      • Medical education fact check
      • Men's health fact check
      • Respiratory fact check
      • Skin and hair care fact check
      • Vaccine and Immunization fact check
      • Women's health fact check
  • AYUSH
    • Ayurveda
    • Homeopathy
    • Siddha
    • Unani
    • Yoga
  • State News
      • Andaman and Nicobar Islands
      • Andhra Pradesh
      • Arunachal Pradesh
      • Assam
      • Bihar
      • Chandigarh
      • Chattisgarh
      • Dadra and Nagar Haveli
      • Daman and Diu
      • Delhi
      • Goa
      • Gujarat
      • Haryana
      • Himachal Pradesh
      • Jammu & Kashmir
      • Jharkhand
      • Karnataka
      • Kerala
      • Ladakh
      • Lakshadweep
      • Madhya Pradesh
      • Maharashtra
      • Manipur
      • Meghalaya
      • Mizoram
      • Nagaland
      • Odisha
      • Puducherry
      • Punjab
      • Rajasthan
      • Sikkim
      • Tamil Nadu
      • Telangana
      • Tripura
      • Uttar Pradesh
      • Uttrakhand
      • West Bengal
  • Medical Education
      • Ayush Education News
      • Dentistry Education News
      • Medical Admission News
      • Medical Colleges News
      • Medical Courses News
      • Medical Universities News
      • Nursing education News
      • Paramedical Education News
      • Study Abroad
  • Industry
      • Health Investment News
      • Health Startup News
      • Medical Devices News
      • Pharma News
      • Pharmacy Education News
      • Industry Perspective
  • MDTV
      • Health Dialogues MDTV
      • Health News today MDTV
      • Latest Videos MDTV
      • Latest Webinars MDTV
      • MD shorts MDTV
      • Medical News Today MDTV
      • Medico Legal Update MDTV
      • Top Videos MDTV
      • Health Perspectives MDTV
      • Journal Club MDTV
      • Medical Dialogues Show
This site is intended for healthcare professionals only
LoginRegister
Medical Dialogues
LoginRegister
  • Home
  • Medical news & Guidelines
    • Anesthesiology
    • Cardiology and CTVS
    • Critical Care
    • Dentistry
    • Dermatology
    • Diabetes and Endocrinology
    • ENT
    • Gastroenterology
    • Medicine
    • Nephrology
    • Neurology
    • Obstretics-Gynaecology
    • Oncology
    • Ophthalmology
    • Orthopaedics
    • Pediatrics-Neonatology
    • Psychiatry
    • Pulmonology
    • Radiology
    • Surgery
    • Urology
    • Laboratory Medicine
    • Diet
    • Nursing
    • Paramedical
    • Physiotherapy
  • Health news
    • Doctor News
    • Government Policies
    • Hospital & Diagnostics
    • International Health News
    • Medical Organization News
    • Medico Legal News
    • NBE News
    • NMC News
  • Fact Check
    • Bone Health Fact Check
    • Brain Health Fact Check
    • Cancer Related Fact Check
    • Child Care Fact Check
    • Dental and oral health fact check
    • Diabetes and metabolic health fact check
    • Diet and Nutrition Fact Check
    • Eye and ENT Care Fact Check
    • Fitness fact check
    • Gut health fact check
    • Heart health fact check
    • Kidney health fact check
    • Medical education fact check
    • Men's health fact check
    • Respiratory fact check
    • Skin and hair care fact check
    • Vaccine and Immunization fact check
    • Women's health fact check
  • AYUSH
    • Ayurveda
      • Ayurveda Giuidelines
      • Ayurveda News
    • Homeopathy
      • Homeopathy Guidelines
      • Homeopathy News
    • Siddha
      • Siddha Guidelines
      • Siddha News
    • Unani
      • Unani Guidelines
      • Unani News
    • Yoga
      • Yoga Guidelines
      • Yoga News
  • State News
    • Andaman and Nicobar Islands
    • Andhra Pradesh
    • Arunachal Pradesh
    • Assam
    • Bihar
    • Chandigarh
    • Chattisgarh
    • Dadra and Nagar Haveli
    • Daman and Diu
    • Delhi
    • Goa
    • Gujarat
    • Haryana
    • Himachal Pradesh
    • Jammu & Kashmir
    • Jharkhand
    • Karnataka
    • Kerala
    • Ladakh
    • Lakshadweep
    • Madhya Pradesh
    • Maharashtra
    • Manipur
    • Meghalaya
    • Mizoram
    • Nagaland
    • Odisha
    • Puducherry
    • Punjab
    • Rajasthan
    • Sikkim
    • Tamil Nadu
    • Telangana
    • Tripura
    • Uttar Pradesh
    • Uttrakhand
    • West Bengal
  • Medical Education
    • Ayush Education News
    • Dentistry Education News
    • Medical Admission News
    • Medical Colleges News
    • Medical Courses News
    • Medical Universities News
    • Nursing education News
    • Paramedical Education News
    • Study Abroad
  • Industry
    • Health Investment News
    • Health Startup News
    • Medical Devices News
    • Pharma News
      • CDSCO (Central Drugs Standard Control Organisation) News
    • Pharmacy Education News
    • Industry Perspective
  • Home
  • Cardiology-CTVS
  • Cardiology & CTVS News
  • Patients who quit...

Patients who quit smoking after PCI do as well as non-smokers-unless they had smoked heavily

Written By : Dr. Kamal Kant Kohli Published On 2023-10-04T11:30:58+05:30  |  Updated On 4 Oct 2023 11:44 AM IST
Quitting smoking
  • facebook
  • twitter
  • linkedin
  • whatsapp
  • Telegram
  • Email

Patients who quit smoking after undergoing percutaneous coronary intervention (PCI) for narrowed arteries have similar outcomes as non-smokers during four years of follow-up after the procedure, according to a large study published in the European Heart Journal today (Wednesday). However, if they had been heavy, long-term smokers, no improvement was seen.

The study of 74,471 patients who had a PCI between 2009 and 2016 is the first, large population-based study to examine the impact of smoking on cardiovascular outcomes, such as death, heart attacks, and strokes, since drug-eluting stents (DES) were first approved for use in PCIs in Europe in 2002 and in the USA in 2003.

A DES is a short wire mesh tube that is inserted into the narrowed artery during PCI and is left in place permanently to allow blood to flow freely. It blocks cell proliferation by releasing a drug over a period of time. This prevents scarring which could narrow the stented artery. PCIs are often performed as an emergency treatment after a heart attack, or when there is a need to enhance blood flow in the coronary arteries, such as when chest pains (angina) can no longer be controlled with medication.

The researchers, led by Professor Jung-Kyu Han, from Seoul National University Hospital, South Korea, analysed data from the Korean National Health Insurance System nationwide database to investigate patient outcomes over four years following PCI. They looked at the rates of heart attacks, strokes, repeated procedures to widen arteries, and deaths from any cause. These are commonly called MACCE (major adverse cardiovascular and cerebrovascular events).

As well as collecting information on factors that could affect the results, such as age, sex, diabetes, blood pressure, alcohol drinking, exercise, body mass index (BMI), medications and socioeconomic status, they also gathered information on whether or not the patients were current smokers, never-smokers, or ex-smokers.

During four years of follow-up, current smokers had a 19.8% higher rate of MACCE than people who had never smoked, and ex-smokers had a comparable rate as never-smokers.

Additionally, they also analysed data from 31,887 patients with information on their smoking habits before and after PCI to further assess the impact of quitting smoking after PCI. They assessed how much patients smoked by placing them in four groups: less than 10 pack years, between 10 and 19 pack years, between 20 and 29 pack years, and over 30 pack years. ‘Pack years’ indicates a person’s accumulated exposure to tobacco; this was reached by multiplying the number of cigarettes smoked a day by the number of years the person had smoked.

Quitters who stopped smoking after PCI and who had smoked less than 20 pack years had a comparable rate of MACCE as people who had never smoked. However, those who had smoked more than 20 pack years before quitting had a 20% higher rate of MACCE, similar to the rate for persistent smokers.

Prof. Han said: “Patients who quit smoking after undergoing percutaneous coronary intervention, with a cumulative smoking exposure of 20 pack years, had cardiovascular risks similar to those of non-smokers. Notably, this finding was observed within a relatively short interval after smoking cessation – a median of 628 days between pre- and post-PCI-health check-ups.”

One of the reasons Prof. Han and his colleagues conducted the study was because most previous research did not consider changes in smoking habits before and after PCI, leaving the effects of quitting smoking after PCI largely unexplored.

He 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. Yet, the revelation that this threshold lies around 20 pack years – not like just five or 10 pack years – was an encouraging discovery. It suggests that smokers undergoing percutaneous coronary intervention, who have not reached a cumulative smoking exposure of 20 pack years, may still have an opportunity to evade the lasting detrimental effects on their cardiovascular outcomes caused by 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. This emphasises the paramount importance of clinicians’ attention to their patients’ smoking status, along with the combined efforts of clinicians, patients, and policymakers in promoting smoking cessation.”

The study also contributes to de-bunking what is known as the “smokers’ paradox”; some previous studies seemed to suggest that smokers who had a heart attack had a better prognosis after PCI.

“A subgroup analysis of our study, which included 28,266 patients with myocardial infarction, refuted this paradox by demonstrating that current smokers had a significantly higher rate of adverse cardiovascular events compared to non-smokers. Notably, the positive impact of smoking cessation in patients with myocardial infarction was not as pronounced as in the overall study population. This may be due to insufficient numbers of patients and events in the subgroup analyses, or because the synergistic effects of heart attack and smoking resulted in more irreversible damage to the myocardium,” said Prof. Han.

A strength of the study is that it’s based on the Korean National Health Insurance System, which covers 97% of the Korean population, and is one of the most comprehensive sources of data on people’s health. Limitations include: whether or not a person smoked and how much was self-reported in a questionnaire and may not reflect the true status; other, unknown factors might affect the findings; the findings cannot be generalised to all races; and pack years cannot differentiate between the impact of long-term smoking at low doses from short-term smoking at high doses.

Reference:

Jung Kyu Han, Hyo-Soo Kim, Kyungdo Han, Smoking and cardiovascular outcomes after percutaneous coronary intervention: a Korean study, European Heart Journal, https://doi.org/10.1093/eurheartj/ehad616.

European Heart Journalpercutaneous coronary interventionsmokingheart attack
Source : European Heart Journal
Dr. Kamal Kant Kohli
Dr. Kamal Kant Kohli

Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: drkohli@medicaldialogues.in. Contact no. 011-43720751

Show Full Article
Next Story

Editorial

ABYSS Trial Finds Elevated BP, HR & Deleterious CV Outcomes After Beta blocker Withdrawal Post-MI: EuroPCR 2025 Update

ABYSS Trial Finds Elevated BP, HR & Deleterious CV Outcomes After Beta blocker Withdrawal Post-MI:...

Aspirin Use in Male Smokers Aged 40-45 Years with Hypertension: Identifying the Ideal Candidates

Aspirin Use in Male Smokers Aged 40-45 Years with Hypertension: Identifying the Ideal Candidates

National Consensus 2025 on Role of Bisoprolol Across CV Continuum in Women: Top 10 Takeaways

National Consensus 2025 on Role of Bisoprolol Across CV Continuum in Women: Top 10 Takeaways

Relevance of Pioglitazone in Indian T2DM Care Continuum

Relevance of Pioglitazone in Indian T2DM Care Continuum

Azmarda Outperforms Generic Sacubitril/Valsartan in HFrEF Management, says new study

Azmarda Outperforms Generic Sacubitril/Valsartan in HFrEF Management, says new study

View All

Journal Club Today

Not Losing Weight? Study Finds Healthy Diet May Still Bring Major Health Gains

Not Losing Weight? Study Finds Healthy Diet May Still Bring Major Health Gains

View All

Health News Today

Health Bulletin 07/June/2025

Health Bulletin 07/June/2025

View All
© 2022 All Rights Reserved.
Powered By: Hocalwire
X
We use cookies for analytics, advertising and to improve our site. You agree to our use of cookies by continuing to use our site. To know more, see our Cookie Policy and Cookie Settings.Ok