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Attenuated physical exercise capacity in smokers compared with non-smokers after coronary angioplasty despite similar
B Jørgensen1, K Endresen, K Forfang
1Department of Cardiology, University of Oslo, Norway.
Insights
Smokers experienced a lower increase in exercise capacity after percutaneous transluminal coronary angioplasty compared to non-smokers. This indicates that smoking may attenuate the clinical benefits of this coronary intervention.
Area of Science:
- Cardiology
- Interventional Cardiology
- Exercise Physiology
Background:
- Percutaneous transluminal coronary angioplasty (PTCA) is a common procedure for treating coronary artery disease.
- Smoking is a major risk factor for cardiovascular disease and may impact treatment outcomes.
- Understanding the influence of smoking on recovery after PTCA is crucial for patient management.
Purpose of the Study:
- To investigate the effect of smoking on exercise capacity changes following PTCA.
- To compare the recovery of exercise capacity between smokers and non-smokers post-PTCA.
Main Methods:
- 368 men under 70 eligible for PTCA were enrolled; 334 completed the study.
- Exercise tests were conducted pre-PTCA and at 2 and 19 weeks post-PTCA.
- Coronary angiography was performed, and angiograms were quantitatively analyzed.
Main Results:
- Smokers were younger than non-smokers (52.4 vs 55.7 years).
- Initial exercise capacity was similar between smokers and non-smokers.
- Non-smokers showed a significantly greater increase in exercise capacity at both 2 and 19 weeks post-PTCA compared to smokers.
Conclusions:
- Both smokers and non-smokers derived clinical benefit from PTCA, as assessed by exercise testing.
- Smokers exhibited a significantly attenuated increase in exercise capacity post-PTCA.
- Smoking appears to reduce the exercise capacity benefits gained from percutaneous transluminal coronary angioplasty.
Aims:
To study the impact of smoking on the change in exercise capacity in patients treated with coronary angioplasty.
Methods:
Three hundred and sixty-eight men below 70 years of age eligible for percutaneous transluminal coronary angioplasty without previous coronary interventions were consecutively enrolled. Of the 334 patients (90.8%) who completed the study 77 (23.1%) were current smokers. Exercise tests were performed before percutaneous transluminal coronary angioplasty, 2 and 19 +/- 2.4 weeks after percutaneous transluminal coronary angioplasty. Coronary angiography was done in 333 patients (99.7%) (at mean 19 +/- 2.4 weeks). The angiograms were analysed quantitatively.
Results:
There were no differences in the clinical and angiographic characteristics among the groups except for age. The non-smokers were older than the smokers (55.7 vs 52.4 years (P = 0.001)). Exercise capacity was equal before percutaneous transluminal coronary angioplasty in both groups (17.6 vs 16.5 W x min-1 x kg-1). Non-smokers had a significantly higher increase in exercise capacity than smokers from baseline to 2 weeks after percutaneous transluminal coronary angioplasty (mean difference 4.3 W x min-1 x kg-1 (95% CI: 2.3 to 6.2; P < 0.001)), and from baseline to 19 weeks after percutaneous transluminal coronary angioplasty (mean difference 3.9 W x min-1 x kg-1 (95% CI: 1.6 to 6.2; P < 0.001).
Conclusion:
A clinical benefit from percutaneous transluminal coronary angioplasty was seen in both groups as judged from exercise testing. Smokers had a substantially lower increase in exercise capacity than non-smokers, indicating an attenuated benefit from percutaneous transluminal coronary angioplasty among smokers.
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