Key result
Cigarette smoking conferred a significantly higher excess risk for MACE in women (HR 3.68; 95% CI 1.86-7.28) compared with men (HR 1.35; 95% CI 1.03-1.77; interaction P=0.026) undergoing PCI.
Why the study?
The study sought to compare the differential effects of cigarette smoking on clinical outcomes in women and men with coronary artery disease undergoing PCI.
Does cigarette smoking differentially impact the risk of MACE in women versus men undergoing elective PCI?
Cohort (n=10,369)
Does cigarette smoking differentially impact the risk of MACE in women versus men undergoing elective PCI?
Effect estimate: HR 3.68 (women), HR 1.35 (men) (95% CI 1.86-7.28 (women), 1.03-1.77 (men))
p-value: p=<.001 (women), .005 (men), interaction P=.026
Cigarette smoking confers a significantly higher excess risk for MACE in women compared to men following elective PCI.
Smoking may confer greater MACE risk in women post-PCI; hypothesis-generating, requires prospective confirmation before guiding practice.
We sought to compare the effects of smoking on clinical outcomes in women and men with coronary artery disease undergoing percutaneous coronary intervention (PCI). We prospectively followed up 10 369 patients undergoing elective PCI. All patients were stratified according to smoking status and sex. The impacts of smoking on long-term major adverse cardiovascular events (MACEs, the composite of all-cause death, myocardial infarction, or target vessel revascularization) were assessed. Among 7773 men and 2596 women undergoing PCI, the prevalence of cigarette smoking was 66.7% (n = 5185) and 11.0% (n = 286; P < .001). During the 3 years of follow-up (median: 20.6 months), smoking increased MACE in both men and women (men 10.8% vs 8.1%, P < .001; women 23.2% vs 6.4%; P < .001). After adjusting for baseline characteristics, smoking had a greater effect on MACE in women (hazard ratio [HR]: 3.68, 95% confidence interval [CI]: 1.86-7.28; P < .001) compared with men (HR: 1.35, 95% CI: 1.03-1.77; P = .005, interaction P = .026). There was a lower prevalence of smoking in women compared to men among patients undergoing PCI. However, smoking confers a higher excess risk for MACE among women compared with men.
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Yang et al. (2019) conducted a cohort in Coronary artery disease (n=10,369). Cigarette smoking vs. Non-smoking was evaluated on Major adverse cardiovascular events (composite of all-cause death, myocardial infarction, or target vessel revascularization) (HR 3.68 (women), HR 1.35 (men), 95% CI 1.86-7.28 (women), 1.03-1.77 (men), p=<.001 (women), .005 (men), interaction P=.026). Cigarette smoking conferred a significantly higher excess risk for MACE in women (HR 3.68; 95% CI 1.86-7.28) compared with men (HR 1.35; 95% CI 1.03-1.77; interaction P=0.026) undergoing PCI.
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