Influence of a history of smoking on short term (six month) clinical and angiographic outcome after successful coronary angioplasty

Abstract

Objectives-To assess the influence of smoking on restenosis after coronary angioplasty. Design and patients-The incidence of smoking on restenosis was investigated in 2948 patients. They were prospectively enrolled in four major restenosis trials in which quantitative angiography was used before and immediately after successful angioplasty and again at six months. Results-Within the study population there were 530 current smokers, 1690 ex-smokers, and 728 non-smokers. Smokers were more likely to be men (85.9% v 87.5% v 65.3%, current v exv non-, p < 0.001), to be younger (54.0 (9.0) v 57.0 (9.1) v 59.9 (9.4) years, p < 0.001), to have peripheral vascular disease (7.2% v 5.5% v 2.3%, p < 0.001), and have sustained a previous myocardial infarction (42.9% v 43.9% v 37.9%, p = 0.022), but were less likely to be diabetic (9.1% v 9.5% v 12.6%, p = 0.043) or hypertensive (24.9% v 29.3% v 37.2, p < 0.001). There was no significant diVerence in the categorical restenosis rate (> 50% diameter stenosis) at six months (35.28% v 35.33% v 37.09%, current v ex-v non-), or the absolute loss (0.29 (0.54) v 0.33 (0.52) v 0.35 (0.55) mm, respectively; p = 0.172). Conclusions-Although smokers have a lower incidence of known predisposing risk factors for atherosclerosis, they require coronary intervention almost six years earlier than non-smokers and three years earlier than ex-smokers. Once they undergo successful coronary angioplasty, there appears to be no evidence that smoking influences their short term (six month) outcome, but because of the known long term eVects of smoking, patients should still be encouraged to discontinue the habit. (Heart 2000;84:299-306)

Clinical and Angiographic Outcomes After Multi-Link PENTA Stent Implantation in Japanese Patients With Coronary Artery Disease

“…Predictive factors of target lesion revascularization: Multiple stents, small vessel (< 3.0 mm), lesion length, coronary risk factors, and stented segment length have been reported to be predictive factors of major adverse cardiac events after coronary stenting. [6][7][8][9][10] However, in the present study, lesion length and small vessel were not identified as predictors of target lesion revascularization. Thus, based on the results of the present study, the ML PENTA stent may be superior with respect to long lesions or small vessels.…”

Isolated Post-Challenge Hyperglycemia in Patients With Normal Fasting Glucose Concentration Exaggerates Neointimal Hyperplasia After Coronary Stent Implantation.

“…38 Recently, Ko et al demonstrated that male smokers had higher plasma glucose concentrations 60 min after an OGTT and more incidence of DM than male non-smokers. 39 Although there is no evidence that cigarette smoking contributes to an adverse clinical outcome after coronary intervention, [40][41][42] it is possible that it may be indirectly related to the restenosis after coronary stent implantation through development of AGT.…”

Early and Late Angiographic and Clinical Outcome Following Helistent Stent Implantation

“…Predictive factors of MACE: It is well known that hypertension, smoking, hypercholesterolemia, and especially diabetes mellitus are independent risk factors for MACE after stent implantation. [22][23][24][25] Thus, we modified these disorders aggressively in our patients, but they still remained as risk factors for MACE. Acute coronary syndromes are also independent risk factors for adverse outcome in stented patients.…”