Cessation of smoking after myocardial infarction. Effects on mortality after 10 years.

Abstract

SUMMARY Ten annual cohorts of men suffering from their first myocardial infarction have been followed up to a maximum period of 10.5 years. One thousand and twenty-three male patients of 1306 were smokers. Three months after the infarction 55% had stopped smoking and 45% continued smoking. These two groups were then compared and followed with regard to non-fatal reinfarctions and deaths.Preinfarction characteristics were shown to be similar for the two groups. The prognostic comparability of the two groups was tested using two multiple logistic models. Those who stopped smoking had a slightly higher predicted two year mortality after the infarction. In different age groups it is shown with life table technique that those who stopped smoking had a considerably higher survival rate and lower cumulative frequency of reinfarction.The present study shows a reversion of the expected prognosis after myocardial infarction caused by changing the smoking habit.Cigarette smoking is one of the major risk factors for the development of coronary heart disease.' I-In a previous report we have shown the beneficial effects of stopping smoking after myocardial infarction. Those who stopped smoking had only half the cardiovascular mortality rate and only half the rate of non-fatal recurrences compared with those who continued to smoke.4 An increased death rate among those who continue to smoke has also been shown by others. S-7 The aim of the present study was to investigate whether our early findings were stable or even enhanced during a prolonged follow-up, and if the proposed effect of changing the smoking habit differed in certain age-groups. Patients and methodsAs from 1 January 1968, all cases of myocardial infarction occurring in Goteborg have been registered by the MI Register.8 The present study comprised men who suffered their first myocardial infarction and

Impact of Smoking Status on Long-Term Mortality in Patients With Acute Myocardial Infarction

“…In fact, the cessation of smoking after AMI has been shown in Western countries to have a beneficial effect on the recurrent adverse events. [5][6][7][8][9][10][11] A recent meta-analysis showed that quitting smoking is associated with reduced risk of total mortality and the pooled crude relative risk was 0.64 (95%CI: 0.58-0.71). 12 In Japan, it has been reported that smoking cessation is associated with reduced second cardiac events (ie, cardiac death and nonfatal MI) in 90 male patients with a history of MI, 27 but that study had the limitations of small sample size, male subjects only and a combined endpoint.…”

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.…”

Fatores de risco cardiovascular e mortalidade: seguimento em longo prazo (até 20 anos) em programa preventivo realizado pela medicina ocupacional

“…Intervention on smoking as objective of primary and secondary prevention of cardiovascular diseases allow for an important reduction of morbimortality, determining a better and greater survival in individuals who stop smoking, of both sexes and in any age range [28][29][30][31][32][33][34][35] .…”