Smoking cessation and outcome after ischemic stroke or TIA

Epstein, Katherine A.; Viscoli, Catherine M.; Spence, J. David; Young, Lawrence H.; Inzucchi, Silvio E.; Gorman, Mark; Gerstenhaber, Brett; Guarino, Peter; Dixit, Anand; Furie, Karen L.; Kernan, Walter N.

doi:10.1212/wnl.0000000000004524

Cited by 74 publications

(57 citation statements)

References 43 publications

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“…Smoking is estimated to be responsible for 12% to 37% of all stroke events. Individuals who smoke approximately 20 cigarettes per day are six times more likely to have a stroke than non-smokers [41]. Smoking increases the risk for vascular disease by induction of a procoagulant state and acceleration of atherosclerosis [41].…”

Section: Discussionmentioning

confidence: 99%

Association of Polymorphisms of the Matrix Metalloproteinase 9 Gene with Ischaemic Stroke in a Southern Chinese Population

Li¹,

Chen²,

Yao³

et al. 2018

Cell Physiol Biochem

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Background/Aims: Matrix metalloproteinase 9 (MMP9), a potent endopeptidase degrading extracellular matrix, plays a pivotal role in the pathogenesis of ischaemic stroke (IS). The present study was undertaken to determine the association of MMP9 gene polymorphisms and the risk of IS in a southern Chinese population. Methods: A cohort of 1274 patients and 1258 age-matched healthy controls were genotyped to detect the four MMP9 polymorphisms (rs17156, rs3787268, rs3918241 and rs3918242) using SNaPshot. Results: Our study demonstrated a significant difference in the genotype and allele frequencies of the MMP9 rs3918242 polymorphism between the IS patients and the controls (P = 0.012 for the genotype and P = 0.0092 for the allele). Stratification by smoking status showed statistically significant differences in the frequency and allele of the rs3918242 polymorphism between IS patients and the controls (P = 0.0052 for the genotype and P = 0.0019 for the allele). Further stratification by IS subtypes revealed that the presence of the T allele of the MMP9 rs3918242 polymorphism confers a higher risk of the large artery atherosclerosis subtype of IS (P = 0.017). Moreover, IS patients with the rs3918242 T allele of MMP9 presented with increased serum MMP9 production, and this increase was more significant in smokers with IS (P = 0.022). Patients carrying the variant T allele of the MMP9 rs3918242 polymorphism exhibited significantly higher infarct volumes than those with the major CC genotype (P = 0.036). Conclusion: Our study provides preliminary evidence that the MMP9 rs3918242 polymorphism is linked to a higher risk of IS, confirming the role of MMP9 in the pathophysiology of IS, with potentially important therapeutic implications.

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Section: Discussionmentioning

confidence: 99%

Association of Polymorphisms of the Matrix Metalloproteinase 9 Gene with Ischaemic Stroke in a Southern Chinese Population

Li¹,

Chen²,

Yao³

et al. 2018

Cell Physiol Biochem

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“…(29) Continued smoking after a stroke or transient ischemic attack, compared to quitting smoking, increases the 5-year risk of another stroke, MI, or death. (30) Continued smoking after an intervention for coronary artery disease also leads to negative outcomes. Among 985 coronary artery bypass graft surgery (CABG) patients followed for a median of 20 years, continuing smokers had a greater risk of all-cause mortality (RR 1.68, 95% CI 1.33–2.13) and cardiac death (1.75, 1.30–2.37) than smokers who quit.…”

Section: Introductionmentioning

confidence: 99%

Prevention and Treatment of Tobacco Use

Kalkhoran

Benowitz

Rigotti

2018

Journal of the American College of Cardiology

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Tobacco use is the leading preventable cause of death worldwide and is a major risk factor for cardiovascular disease (CVD). Both prevention of smoking initiation among youth and smoking cessation among established smokers are key for reducing smoking prevalence and the associated negative health consequences. Proven tobacco cessation treatment includes pharmacotherapy and behavioral support, which are most effective when provided together. First-line medications (varenicline, bupropion, and nicotine replacement) are effective and safe for patients with CVD. Clinicians who care for patients with CVD should give as high a priority to treating tobacco use as to managing other CVD risk factors. Broader tobacco control efforts to raise tobacco taxes, adopt smoke-free laws, conduct mass media campaigns, and restrict tobacco marketing enhance clinicians' actions working with individual smokers.

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“…In the Insulin Resistance Intervention After Stroke trial, smoking cessation after stroke was associated with a 34% reduction of the 5-year risk of stroke and MI or vascular death . 5 On a population basis, however, interventions by government would be more likely to make a big difference. Banning smoking in public places, preventing sales of tobacco to minors, increasing taxation on tobacco products and printing smoke prevention messages on tobacco packaging are examples of such interventions that can make a difference.…”

Section: Opportunities For Stroke Prevention Arising From the Data Smmentioning

confidence: 99%

China Stroke Statistics 2019: a wealth of opportunities for stroke prevention

Spence

2020

Stroke Vasc Neurol

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Smoking cessation and outcome after ischemic stroke or TIA

Abstract: Cessation of cigarette smoking after an ischemic stroke or TIA was associated with significant health benefits over 4.8 years in the IRIS trial cohort.

Cited by 74 publications

References 43 publications

Association of Polymorphisms of the Matrix Metalloproteinase 9 Gene with Ischaemic Stroke in a Southern Chinese Population

Association of Polymorphisms of the Matrix Metalloproteinase 9 Gene with Ischaemic Stroke in a Southern Chinese Population

Prevention and Treatment of Tobacco Use

China Stroke Statistics 2019: a wealth of opportunities for stroke prevention

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