Long term effect on mortality of stopping smoking after unstable angina and myocardial infarction.

Abstract

Subjects who stop smoking cigarettes after myocardial infarction have an improved rate of survival compared with those who continue, but to date it was not known whether the benefit persisted for more than six years. A total of 498 men aged under 60 years who had survived a first episode of unstable angina or myocardial infarction by two years were followed up by life table methods for a further 13 years. Mortality in those who continued to smoke was significantly higher (82 1 %) than in those who stopped smoking (36-9%). These differences increased with time. Mortality in those who were non-smokers initially and who continued not to smoke was intermediate (62 1%). The adverse effect of continued smoking was most pronounced in those with unstable angina. Continuing to smoke increased the rate of sudden death to a greater degree in those with less severe initial attacks, while the effect of smoking on fatal reinfarctions was most apparent in those with a more complicated presentation.These findings suggest that stopping cigarette smoking is the most effective single action in the management of patients with coronary heart disease.

The Birmingham Rehabilitation Uptake Maximisation Study (BRUM). Home-based compared with hospital-based cardiac rehabilitation in a multi-ethnic population: cost-effectiveness and patient adherence

“…If a CR programme has a high patient uptake and adherence and is effective, it will lead to reductions in risk factors, which in turn should translate to a reduction in cardiac events. 48,[105][106][107][108][109][110][111][112][113][114] At 1 year mortality rates are low (6% in Jolly and colleagues 115 ) and it is unlikely that one would see a reduction in cardiac events. It is also possible that revascularisation rates could be associated with participation in a particular rehabilitation programme.…”

The association among depressive symptoms, smoking status and antidepressant use in cardiac outpatients

“…Smoking cessation is the most effective lifestyle modification in the management of patients with CAD (Critchley and Capewell, 2004;Daly et al, 1983) as smoking-related cardiovascular events are significantly reduced within one year (Thomson and Rigotti, 2003). Further, quitting smoking can reduce the risk of MI to that of a non-smoker over time (Health Canada, 2008;Wilhelmsen, 1998;Thomson and Rigotti, 2003).…”

“…Smoking is associated with increased all-cause morbidity and mortality in the general population (Health Canada, 2008;Centers for Disease Control and Prevention (CDC), 2002) and has adverse prognostic consequences in patients with established coronary artery disease (CAD) (Prugger et al, 2008;Daly et al, 1983;De Bacquer et al, 2003). For example, continued smoking in CAD patients is associated with non-fatal myocardial infarctions, recurrent coronary events, the lowering of high-density lipoprotein cholesterol, restenosis and all-cause mortality (Critchley and Capewell, 2004;Rea et al, 2002;Johansson et al, 1985;Ronnevik et al, 1985;Salonen et al, 1980;Wilson et al, 2000;Perkins and Dick, 1985;Kinjo et al, 2005;Serrano et al, 2003;Kwiterovich et al, 1998).…”

Cardiovascular Risk Factor Clustering and Coronary Artery Disease : A 4-Year Follow Up Study of 257 Service Personnel

“…Since this ideal control group could not be studied for comparison, the improvements achieved in stress test results after 4 years of control of risk factors lose some amount of significance. Nevertheless, enough evidence is available in current world literature, to prove that control or abolition of risk factors playa major role in overall improvement of IHD patients including their response to stress tests [6,[20][21][22][23][24][25].…”