Emily M Bucholz1, Adam L Beckman2, Catarina I Kiefe3, Harlan M Krumholz4. 1. Department of Medicine, Boston Children's Hospital, Boston, Massachusetts, USA. 2. Yale School of Medicine and Yale School of Public Health, New Haven, Connecticut, USA. 3. Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA. 4. Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut, USA Section of Health Policy and Administration, School of Public Health, Yale University School of Medicine, New Haven, Connecticut, USA.
Abstract
OBJECTIVE: Smokers have lower short-term mortality after acute myocardial infarction (AMI) than non-smokers; however, little is known about the long-term effects of smoking on life expectancy after AMI. This study aimed to quantify the burden of smoking after AMI using life expectancy and years of life lost. METHODS: We analysed data from the Cooperative Cardiovascular Project, a medical record study of 158,349 elderly Medicare patients with AMI and over 17 years of follow-up, to evaluate the age-specific association of smoking with life expectancy and years of life lost after AMI. RESULTS: Our sample included 23,447 (14.8%) current smokers. Current smokers had lower crude mortality up to 5 years, which was largely explained by their younger age at AMI. After adjustment other patient characteristics, smoking was associated with lower 30-day (HR 0.91, 95% CI 0.87 to 0.94) but higher long-term mortality (17-year HR 1.19, 95% CI 1.17 to 1.20) after AMI. Overall, crude life expectancy estimates were lower for current smokers than non-smokers at all ages, which translated into sizeable numbers of life-years lost attributable to smoking. As age at AMI increased, the magnitude of life-years lost due to smoking decreased. After full risk adjustment, the differences in life expectancy between current smokers and non-smokers persisted at all ages. CONCLUSIONS: Current smoking is associated with lower life expectancy and large numbers of life-years lost after AMI. Our findings lend additional support to smoking cessation efforts after AMI. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
OBJECTIVE: Smokers have lower short-term mortality after acute myocardial infarction (AMI) than non-smokers; however, little is known about the long-term effects of smoking on life expectancy after AMI. This study aimed to quantify the burden of smoking after AMI using life expectancy and years of life lost. METHODS: We analysed data from the Cooperative Cardiovascular Project, a medical record study of 158,349 elderly Medicare patients with AMI and over 17 years of follow-up, to evaluate the age-specific association of smoking with life expectancy and years of life lost after AMI. RESULTS: Our sample included 23,447 (14.8%) current smokers. Current smokers had lower crude mortality up to 5 years, which was largely explained by their younger age at AMI. After adjustment other patient characteristics, smoking was associated with lower 30-day (HR 0.91, 95% CI 0.87 to 0.94) but higher long-term mortality (17-year HR 1.19, 95% CI 1.17 to 1.20) after AMI. Overall, crude life expectancy estimates were lower for current smokers than non-smokers at all ages, which translated into sizeable numbers of life-years lost attributable to smoking. As age at AMI increased, the magnitude of life-years lost due to smoking decreased. After full risk adjustment, the differences in life expectancy between current smokers and non-smokers persisted at all ages. CONCLUSIONS: Current smoking is associated with lower life expectancy and large numbers of life-years lost after AMI. Our findings lend additional support to smoking cessation efforts after AMI. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Authors: G K Andrikopoulos; D J Richter; P E Dilaveris; A Pipilis; A Zaharoulis; J E Gialafos; P K Toutouzas; E T Chimonas Journal: Eur Heart J Date: 2001-05 Impact factor: 29.983
Authors: Lan Shen; Eric D Peterson; Shuang Li; Laine Thomas; Karen Alexander; Ying Xian; Tracy Y Wang; Matthew T Roe; Ben He; Bimal R Shah Journal: Am Heart J Date: 2013-10-25 Impact factor: 4.749
Authors: Kenji Goto; Eugenia Nikolsky; Alexandra J Lansky; George Dangas; Bernhard Witzenbichler; Helen Parise; Giulio Guagliumi; Ran Kornowski; Bimmer E Claessen; Martin Fahy; Roxana Mehran; Gregg W Stone Journal: Am J Cardiol Date: 2011-08-23 Impact factor: 2.778
Authors: John G Canto; Catarina I Kiefe; William J Rogers; Eric D Peterson; Paul D Frederick; William J French; C Michael Gibson; Charles V Pollack; Joseph P Ornato; Robert J Zalenski; Jan Penney; Alan J Tiefenbrunn; Philip Greenland Journal: Am J Cardiol Date: 2012-07-27 Impact factor: 2.778
Authors: Tomasz Rakowski; Zbigniew Siudak; Artur Dziewierz; Jacek S Dubiel; Dariusz Dudek Journal: J Thromb Thrombolysis Date: 2012-10 Impact factor: 2.300
Authors: Matias B Yudi; Omar Farouque; Nick Andrianopoulos; Andrew E Ajani; Katie Kalten; Angela L Brennan; Jeffrey Lefkovits; Chin Hiew; Ernesto Oqueli; Christopher M Reid; Stephen J Duffy; David J Clark Journal: BMJ Open Date: 2017-10-06 Impact factor: 2.692