Key result
Current smoking was associated with higher 30-day mortality following PCI compared with never-smoking (adjusted OR 1.60; 95% CI 1.10-2.32), whereas ex-smokers had similar mortality.
Why the study?
Data on the effect of smoking on mortality following percutaneous coronary intervention are lacking in the modern PCI era.
Does smoking status impact short- and intermediate-term mortality in patients undergoing PCI?
Observational (n=12,656)
Does smoking status impact short- and intermediate-term mortality in patients undergoing PCI?
Effect estimate: OR 1.60 (95% CI 1.10-2.32)
Current smokers undergo PCI at a younger age and have higher 30-day mortality compared to never-smokers, highlighting the harmful effects of smoking and benefits of cessation.
Current smoking may raise 30-day post-PCI mortality risk; this observational association leaves causal effects of cessation open.
OBJECTIVE: The aim of this study was to assess the impact of smoking on short (30-day) and intermediate (30-day to 6-month) mortality following percutaneous coronary intervention (PCI). BACKGROUND: The effect of smoking on mortality post-PCI is lacking in the modern PCI era. METHODS: This was a retrospective analysis of prospectively collected data comparing short- and intermediate-term mortality amongst smokers, ex-smokers and non-smokers. RESULTS: The study cohort consisted of 12,656 patients: never-smokers (n = 4288), ex-smokers (n = 4806) and current smokers (n = 3562). The mean age (±standard deviation) was 57 (±11) years in current smokers compared with 67 (±11) in ex-smokers and 67 (±12) in never-smokers; p < 0.0001. PCI was performed for acute coronary syndrome (ACS) in 84.1% of current smokers, 57% of ex-smokers and 62.9% in never-smokers; p < 0.0001. In a logistic regression model, the adjusted odds ratios (95% confidence intervals (CIs)) for 30-day mortality were 1.60 (1.10-2.32) in current smokers and 0.98 (0.70-1.38) in ex-smokers compared with never-smokers. In the Cox proportional hazard model, the adjusted hazard ratios (95% CI) for mortality between 30 days and 6 months were 1.03 (0.65-1.65) in current smokers and 1.19 (0.84-1.67) in ex-smokers compared with never-smokers. CONCLUSION: This large observational study of non-selected patients demonstrates that ex-smokers and never-smokers are of similar age at first presentation to PCI, and there is no short- or intermediate-term mortality difference between them following PCI. Current smokers undergo PCI at a younger age, more often for ACS, and have higher short-term mortality. These findings underscore the public message on the benefits of smoking cessation and the harmful effects of smoking.
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Parasuraman et al. (2020) conducted an observational in Post-percutaneous coronary intervention (PCI) (n=12,656). Current smoking vs. Never-smokers was evaluated on 30-day mortality (OR 1.60, 95% CI 1.10-2.32). Current smoking was associated with higher 30-day mortality following PCI compared with never-smoking (adjusted OR 1.60; 95% CI 1.10-2.32), whereas ex-smokers had similar mortality.
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