M Johanneke van den Berg1, Yolanda van der Graaf2, Jaap W Deckers3, Wanda de Kanter4, Ale Algra5, L Jaap Kappelle6, Gert J de Borst7, Maarten-Jan M Cramer8, Frank L J Visseren9. 1. Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands; Department of Anesthesiology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands. 2. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. 3. Department of Cardiology, Thoraxcenter Erasmus Medical Centre, Rotterdam, The Netherlands. 4. Department of Thorax oncology, Antoni van Leeuwenhoek, Netherlands Cancer Institute, Amsterdam, The Netherlands. 5. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands; Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands. 6. Department of Neurology and Neurosurgery, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands. 7. Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands. 8. Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands. 9. Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands. Electronic address: F.L.J.Visseren@umcutrecht.nl.
Abstract
AIMS: To quantify the relation between smoking cessation after a first cardiovascular (CV) event and risk of recurrent CV events and mortality. METHODS: Data were available from 4,673 patients aged 61 ± 8.7 years, with a recent (≤1 year) first manifestation of arterial disease participating in the SMART-cohort. Cox models were used to quantify the relation between smoking status and risk of recurrent major atherosclerotic cardiovascular events (MACE including stroke, MI and vascular mortality) and mortality. In addition, survival according to smoking status was plotted, taking competing risk of non-vascular mortality into account. RESULTS: A third of the smokers stopped after their first CV event. During a median of 7.4 (3.7-10.8) years of follow-up, 794 patients died and 692 MACE occurred. Compared to patients who continued to smoke, patients who quit had a lower risk of recurrent MACE (adjusted HR 0.66, 95% CI 0.49-0.88) and all-cause mortality (adjusted HR 0.63, 95% CI 0.48-0.82). Patients who reported smoking cessation on average lived 5 life years longer and recurrent MACE occurred 10 years later. In patients with a first CV event >70 years, cessation of smoking had improved survival which on average was comparable to former or never smokers. CONCLUSIONS: Irrespective of age at first CV event, cessation of smoking after a first CV event is related to a substantial lower risk of recurrent vascular events and all-cause mortality. Since smoking cessation is more effective in reducing CV risk than any pharmaceutical treatment of major risk factors, it should be a key objective for patients with vascular disease.
AIMS: To quantify the relation between smoking cessation after a first cardiovascular (CV) event and risk of recurrent CV events and mortality. METHODS: Data were available from 4,673 patients aged 61 ± 8.7 years, with a recent (≤1 year) first manifestation of arterial disease participating in the SMART-cohort. Cox models were used to quantify the relation between smoking status and risk of recurrent major atherosclerotic cardiovascular events (MACE including stroke, MI and vascular mortality) and mortality. In addition, survival according to smoking status was plotted, taking competing risk of non-vascular mortality into account. RESULTS: A third of the smokers stopped after their first CV event. During a median of 7.4 (3.7-10.8) years of follow-up, 794 patientsdied and 692 MACE occurred. Compared to patients who continued to smoke, patients who quit had a lower risk of recurrent MACE (adjusted HR 0.66, 95% CI 0.49-0.88) and all-cause mortality (adjusted HR 0.63, 95% CI 0.48-0.82). Patients who reported smoking cessation on average lived 5 life years longer and recurrent MACE occurred 10 years later. In patients with a first CV event >70 years, cessation of smoking had improved survival which on average was comparable to former or never smokers. CONCLUSIONS: Irrespective of age at first CV event, cessation of smoking after a first CV event is related to a substantial lower risk of recurrent vascular events and all-cause mortality. Since smoking cessation is more effective in reducing CV risk than any pharmaceutical treatment of major risk factors, it should be a key objective for patients with vascular disease.
Authors: Gregory Y H Lip; Deirdre A Lane; Radosław Lenarczyk; Giuseppe Boriani; Wolfram Doehner; Laura A Benjamin; Marc Fisher; Deborah Lowe; Ralph L Sacco; Renate Schnabel; Caroline Watkins; George Ntaios; Tatjana Potpara Journal: Eur Heart J Date: 2022-07-07 Impact factor: 35.855
Authors: Tamar Irene de Vries; Jan Westerink; Michiel L Bots; Folkert W Asselbergs; Yvo M Smulders; Frank L J Visseren Journal: BMJ Open Date: 2021-03-08 Impact factor: 2.692
Authors: Lorena Ciumărnean; Mircea Vasile Milaciu; Vasile Negrean; Olga Hilda Orășan; Stefan Cristian Vesa; Octavia Sălăgean; Silvina Iluţ; Sonia Irina Vlaicu Journal: Int J Environ Res Public Health Date: 2021-12-25 Impact factor: 3.390