Coronary disease & ACS

Smoking and cardiovascular outcomes after percutaneous coronary intervention: a Korean study

Eur Heart JPublished Retrospective cohort study

Authors' conclusion

Smoking is associated with a higher risk of adverse outcomes in patients undergoing PCI. Quitters after PCI with <20 PYs were associated with a risk comparable with that of non-smokers.

Study context

Population
Patients undergoing Percutaneous Coronary Intervention (PCI), Korean National Health Insurance System, 2009–2016
Participants
74,471 patients
Exposure
Current smokers and ex-smokers vs non-smokers after PCI
Outcome
MACCE:
  • All-cause death
  • MI
  • Coronary revascularization
  • Stroke
Follow-up
4.0 years
Methodological detailsnationwide database
  • Nationwide database

Main finding

As reported in the abstract

MACCE · 4.0 years
Each group vs non-smokersAdjusted hazard ratio (95% CI)
Current smokers19.8% higher rate
1.198(1.137–1.263)
Ex-smokers
1.036(.992-1.081)

Observational data: associations, not effects.

Further findings

OutcomeaHR (95% CI)
MACCE by smoking cessation and cumulative exposure (pre- and post-PCI check-up data)Quitters <10 PYvs Persistent non-smokers1.182 (.971-1.438)
MACCE by smoking cessation and cumulative exposure (pre- and post-PCI check-up data)Quitters 10-20 PYsvs Persistent non-smokers1.114 (.963-1.290)
MACCE by smoking cessation and cumulative exposure (pre- and post-PCI check-up data)Quitters 20-30 PYsvs Persistent non-smokers1.206 (1.054–1.380)
MACCE by smoking cessation and cumulative exposure (pre- and post-PCI check-up data)Quitters ≥30 PYsvs Persistent non-smokers1.227 (1.113–1.352)
MACCE by smoking cessation and cumulative exposure (pre- and post-PCI check-up data)Persistent smokersvs Persistent non-smokers1.223 (1.126–1.328)
  • Major adverse cardiovascular and cerebrovascular event (MACCE) by smoking cessation and cumulative exposure (pre- and post-PCI check-up data): n = 31 887 analysed
  • MACCE by smoking cessation and cumulative exposure (pre- and post-PCI check-up data): P for interaction <.001

Original publication

Smoking and cardiovascular outcomes after percutaneous coronary intervention: a Korean study. Eur Heart J. Published 26 September 2023. doi:10.1093/eurheartj/ehad616

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