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Early predictors of smoking cessation after myocardial infarction
M Di Tullio1, D Granata, E Taioli
1II Divisione Cardiologica, Ospedale Niguarda Ca Granda, Milan, Italy.
Insights
Longer hospital stays and higher peak creatine phosphokinase (CPK) levels predict successful long-term smoking cessation after myocardial infarction. Intensive cardiac rehabilitation programs are key for sustained quitting.
Area of Science:
- Cardiology
- Public Health
- Behavioral Science
Background:
- Smoking is a major risk factor for myocardial infarction (MI).
- Sustained smoking cessation is crucial for secondary prevention after MI.
- Identifying predictors of long-term cessation can optimize interventions.
Purpose of the Study:
- To evaluate determinants of long-term smoking cessation in MI survivors.
- To identify patient characteristics and treatment factors associated with sustained quitting.
Main Methods:
- Prospective evaluation of 80 patients post-myocardial infarction.
- In-hospital counseling and physician-guided follow-up sessions at 1, 3, and 6 months.
- Assessment of smoking status at 18 months post-discharge.
Main Results:
- Overall smoking cessation rate was 66.3% at 18 months.
- Longer hospital stay (≥19 days) was associated with higher cessation rates (79% vs. 48%, p<0.005).
- Higher peak creatine phosphokinase (CPK) elevation (≥500 U/l) also correlated with increased cessation (76% vs. 54%, p<0.05).
- Logistic regression identified hospital stay duration as a significant predictor (p<0.005).
Conclusions:
- Longer hospitalizations and elevated CPK levels are positive predictors of sustained smoking cessation post-MI.
- Early and intensive secondary prevention during hospitalization is vital for promoting long-term smoking cessation in MI survivors.
Abstract:
The determinants of long-term smoking cessation were evaluated in 80 patients who smoked cigarettes and survived a myocardial infarction. All patients underwent a program of rehabilitation and secondary prevention including in-hospital counseling and physician-guided reinforcing sessions at 1, 3, and 6 months after discharge. At 18 months of follow-up, 53 patients (66.3%) had quit smoking. Variables associated with smoking cessation were duration of hospital stay greater than or equal to 19 days (79 vs. 48%; p less than 0.005) and peak creatine phosphokinase (CPK) elevation greater than or equal to 500 U/l (76 vs. 54%; p less than 0.05). Males tended to quit in higher proportion than females (68 vs. 44%). Age, prior myocardial infarction, other cardiovascular risk factors, infarction location, Killip class at entry, and duration of stay in coronary care unit did not significantly affect the quitting rates. Logistic regression analysis singled out the duration of hospital stay as a significant predictor of smoking cessation (p less than 0.005). Early and intensive secondary prevention during the hospital stay is crucial in promoting sustained smoking cessation after myocardial infarction.