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Background Smoking cessation is an effective secondary prevention measure after acute coronary syndrome (ACS). We conducted a systematic review with the aim to better understand which patients have a greater propensity to quit smoking and the risk factors for continued smoking after ACS. Methods We searched MEDLINE and EMBASE for studies that evaluated smoking cessation after ACS. The pooled rate of smoking cessation across included studies was performed. Random effects meta‐analysis for different variables and their association with smoking cessation was conducted. Results A total of 39 studies with 11 228 patients were included in this review. The pooled rate of smoking cessation following ACS across 38 studies was 45.0%. Factors associated with greater likelihood of smoking cessation were attendance at cardiac rehabilitation (OR 1.90 95% CI 1.44‐2.51), married/not alone (OR 1.68 95% CI 1.32‐2.13), intention/attempt to quit smoking (OR 1.27 95% CI 1.11‐1.46), diabetes mellitus (OR 1.24 95% CI 1.03‐1.51) and hospitalised duration (OR 1.09 95% CI 1.02‐1.15). Variables associated with a lower likelihood of smoking cessation were depression (OR 0.57 95% CI 0.43‐0.75), chronic obstructive pulmonary disease/lung disease (OR 0.73 95% CI 0.57‐0.93), previous admission with acute myocardial infarction/cardiac admission (OR 0.61 95% CI 0.47‐0.80), cerebrovascular disease/transient ischaemic attack (OR 0.42 95% CI 0.30‐0.58) and unemployment (OR 0.37 95% CI 0.17‐0.80). Conclusions The majority of smokers with an ACS continue to smoke after admission. Patients attending cardiac rehabilitation show increased odds of quitting while people who are depressed and those with chronic lung disease were less likely to quit smoking and should be targeted for intensive smoking cessation interventions.

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Nurses can have a major impact on the care of patients with iron deficiency and heart failure. Identifying and treating iron deficiency in patients with heart failure can reduce hospitalisations and improve quality of life. There is evidence to suggest that oral iron is ineffective in treating iron deficiency in this patient group, but studies with intravenous iron have demonstrated benefits. Nurses with knowledge of iron deficiency in heart failure can recognise symptoms and suggest that the patient is evaluated for this problem. The nature of the holistic care that nurses provide may enable early detection of malnourishment and melaena, as well as less apparent symptoms associated with iron deficiency. This nursing relationship with patients could also help to identify issues such as non-compliance to oral iron therapy and, in these circumstances, nurses could then advocate for switching to more effective intravenous therapy. Overall, nurses have the opportunity to positively impact the care of patients with heart failure and iron deficiency through early recognition of patients at risk, blood testing and interpretation, consideration of potential causes and advocacy of intravenous therapy.