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Long term effect on mortality of stopping smoking after unstable angina and myocardial infarction
Insights
Stopping smoking after a heart attack significantly improves long-term survival rates. This crucial lifestyle change offers the most effective benefit for patients with coronary heart disease.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Smoking cessation after myocardial infarction (MI) improves survival, but long-term benefits beyond six years were unclear.
- Understanding the sustained impact of smoking on post-MI mortality is critical for patient management.
Purpose of the Study:
- To evaluate the long-term survival rates of patients who stopped smoking versus those who continued after a first myocardial infarction (MI) or unstable angina.
- To assess the impact of continued smoking on mortality over a 13-year follow-up period.
Main Methods:
- A cohort of 498 men under 60, survivors of a first MI or unstable angina, were followed for 13 years post-MI.
- Life table methods were used to analyze mortality rates between smokers and non-smokers.
Main Results:
- Mortality was significantly higher in patients who continued smoking (82.1%) compared to those who quit (36.9%).
- The survival benefit of smoking cessation increased over time.
- Non-smokers had intermediate mortality rates (62.1%).
- Continued smoking had a more pronounced adverse effect in patients with unstable angina and was linked to increased sudden death and fatal reinfarctions.
Conclusions:
- Stopping cigarette smoking is the most effective single intervention for managing patients with coronary heart disease.
- Long-term cessation of smoking after MI provides a sustained survival advantage.
Abstract:
Subjects who stop smoking cigarettes after myocardial infarction have an improved rate of survival compared with those who continue, but to date it was not known whether the benefit persisted for more than six years. A total of 498 men aged under 60 years who had survived a first episode of unstable angina or myocardial infarction by two years were followed up by life table methods for a further 13 years. Mortality in those who continued to smoke was significantly higher (82.1%) than in those who stopped smoking (36.9%). These differences increased with time. Mortality in those who were non-smokers initially and who continued not to smoke was intermediate (62.1%). The adverse effect of continued smoking was most pronounced in those with unstable angina. Continuing to smoke increased the rate of sudden death to a greater degree in those with less severe initial attacks, while the effect of smoking on fatal reinfarctions was most apparent in those with a more complicated presentation. These findings suggest that stopping cigarette smoking is the most effective single action in the management of patients with coronary heart disease.