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April 10, 2000Archives of Internal Medicine

Effect of Smoking Cessation on Mortality After Myocardial Infarction

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Why the study?

Does smoking cessation reduce mortality in patients after myocardial infarction?

Population

12 cohort studies pooling 5,878 patients who had a myocardial infarction.

Comparison

Smoking cessation after myocardial infarction vs Continued smoking after myocardial infarction

Design

Meta-analysis

Follow-up

2 to 10 years

Authors

KWKumanan WilsonUniversity of OttawaNGNeil E. GibsonUniversity of AlbertaAWAndrew R. WillanUniversity of Toronto

Discussion

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Implication

Smoking cessation after MI reduces mortality; reinforces secondary prevention guidelines with pooled evidence.

Key Points

  • To determine the impact of smoking cessation on mortality among patients following myocardial infarction.
  • Systematic review of English- and non-English-language cohort studies published between 1966 and 1996 identified through MEDLINE and EMBASE.
  • Included 12 cohort studies across 6 countries (conducted 1949–1988) comprising N=5,878 post-myocardial infarction patients with follow-up durations ranging from 2 to 10 years.
  • Extracted mortality data to compare patients who quit smoking versus those who continued smoking using a random effects model.
  • Smoking cessation after myocardial infarction was associated with a significant reduction in mortality (pooled OR 0.54, 95% CI, 0.46–0.62).
  • Relative risk reductions across included studies ranged from 15% to 61%, yielding a number needed to quit of 13 to save one life assuming a 20% mortality rate in continuing smokers.
  • The mortality benefit of smoking cessation was consistent regardless of sex, follow-up duration, study site, and time period.

Structured PICO

Does smoking cessation reduce mortality in patients after myocardial infarction?

P
Population
12 cohort studies pooling 5,878 patients who had a myocardial infarction.
I
Intervention
Smoking cessation after myocardial infarction
C
Comparator
Continued smoking after myocardial infarction
O
Outcome
Mortality (death after myocardial infarction)hard clinical

Smoking cessation after a myocardial infarction significantly reduces mortality, with a number needed to quit of 13 to save one life.

Cite This Study

Wilson et al. (2000) studied this question.

synapsesocial.com/papers/6a7d2448d685fe2c2d7757e0https://doi.org/10.1001/archinte.160.7.939
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Smoking Habits in Consecutive Patients with Acute Myocardial Infarction: Prognosis in Relation to Other Risk Indicators and to Whether or Not they Quit Smoking2008 · 29 citations
  2. 2Smoking and Myocardial Infarction1977 · 274 citations
  3. 3Haematological prognostic indices after myocardial infarction: evidence from the diet and reinfarction trial (DART)1992 · 129 citations
  4. 4Cumulative Meta-Analysis of Therapeutic Trials for Myocardial Infarction1992 · 1,156 citations
  5. 5Norepinephrine and Epinephrine Release and Adrenergic Mediation of Smoking-Associated Hemodynamic and Metabolic Events1976 · 1,111 citations