Key result
Baseline smoking in DES PCI is linked to ~60% higher 10-year risk of major events.
Why the study?
Studies investigating 10-year outcomes according to baseline smoking status in a large-scale population undergoing PCI with DES implantation are scarce.
Does smoking at baseline affect 10-year outcomes including all-cause death in patients undergoing PCI with DES implantation?
Meta-Analysis
Yes
Does smoking at baseline affect 10-year outcomes including all-cause death in patients undergoing PCI with DES implantation?
Effect estimate: 1.60 (95% CI 1.36-1.90)
In patients undergoing PCI with DES, baseline smoking is associated with higher 10-year risks of death, MI, and stent thrombosis, despite a paradoxically lower risk of repeat revascularization.
Supports intensified smoking cessation at PCI; confirms elevated 10-year risks of death, MI, and stent thrombosis.
BACKGROUND: Studies investigating 10-year outcomes according to smoking status at baseline in a largescale population undergoing percutaneous coronary intervention (PCI) with drug-eluting stent (DES) implantation are scarce. OBJECTIVES: The authors sought to assess the association between smoking status at baseline and 10-year outcomes after PCI with DES implantation. METHODS: We pooled individual participant data from 5 randomized trials including patients with 10-year follow-up after DES implantation. We divided participants into 2 groups as per smoking status at baseline. The main outcome was all-cause death. Secondary outcomes included cardiovascular death, myocardial infarction (MI), definite stent thrombosis (ST), and repeat revascularization (of target lesion, target vessel [TVR], or non-target vessel). RESULTS: : 1.60; 95% CI: 1.36-1.90). Smoking was associated with a lower risk of target lesion revascularization and target vessel revascularization, but a comparable risk of non-target vessel revascularization. CONCLUSIONS: In patients undergoing PCI with DES, smoking at baseline is associated with an increased risk of death, MI, and ST, but a lower risk of repeat revascularization through to 10 years.
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Presch et al. (2025) conducted a meta-analysis in Percutaneous coronary intervention with drug-eluting stent implantation. Smoking at baseline vs. Non-smoking at baseline was evaluated on All-cause death (1.60, 95% CI 1.36-1.90). Smoking at baseline in patients undergoing PCI with DES was associated with an increased risk of death, MI, and stent thrombosis (effect size 1.60; 95% CI 1.36-1.90) through 10 years.
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