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Three life-years gained from smoking cessation after coronary artery bypass surgery: a 30-year follow-up study

Ron T van Domburg1, Wilma Scholte op Reimer, Sanne E Hoeks

  • 1Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands. r.vandomburg@erasmusmc.nl

American Heart Journal
|September 2, 2008
PubMed

Insights

Smoking cessation after coronary artery bypass surgery significantly prolonged life expectancy by an average of 3 years. Quitting smoking after heart surgery offers greater survival benefits than other treatments.

Area of Science:

  • Cardiovascular Surgery
  • Public Health
  • Clinical Outcomes Research

Background:

  • Smoking cessation post-cardiac event reduces mortality risk.
  • The impact of smoking cessation on life-years gained after coronary artery bypass surgery (CABG) remains understudied.

Purpose of the Study:

  • To determine the long-term effect of smoking cessation on life expectancy in patients who underwent isolated venous coronary artery bypass surgery.
  • To quantify the life-years gained by patients who quit smoking versus those who continued.

Main Methods:

  • Analysis of 30-year clinical outcomes for 1,041 patients undergoing isolated venous CABG between 1971-1980.
  • Inclusion of 551 patients who were smokers at the time of surgery, categorizing them into quitters (43%) and persistent smokers (57%).
  • Utilizing Kaplan-Meier curves to calculate and compare life expectancy between the two groups.

Main Results:

  • Patients who quit smoking demonstrated significantly higher cumulative survival rates at 10, 20, and 30 years compared to persistent smokers (P < .0001).
  • Smoking cessation was an independent predictor of lower mortality, with a hazard ratio of 0.60 (95% CI 0.48-0.72) after adjustments.
  • Life expectancy was 20.0 years for quitters versus 17.0 years for persistent smokers, a difference of 3 years (P < .0001).

Conclusions:

  • Self-reported smoking cessation following CABG is associated with an estimated gain of 3 life-years.
  • Smoking cessation provides a more substantial reduction in mortality risk than any other intervention or treatment studied in this cohort.
Abstract

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