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| Residual cardiovascular risk after smoking cessation in patients with acute coronary syndrome undergoing percutaneous coronary intervention |
| Received:July 06, 2022 |
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| DOI：10.11915/j.issn.1671-5403.2023.01.003 |
| Key words:cardiovascular disease smoking smoking cessation risk This work was supported by Liaoning Natural Science Foundation Program Project |
| Author Name | Affiliation | E-mail | | LI Jing | Department of Cardiovascular Medicine, Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
Department of Cardiovascular Medicine, General Hospital of Northern Theater Command, Shenyang 110016, China | hanyaling@263.netresidual | | LI Peng-Xiao | Department of Cardiovascular Medicine, General Hospital of Northern Theater Command, Shenyang 110016, China | hanyaling@263.netresidual | | QI Zi-Zhao | Department of Cardiovascular Medicine, Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
Department of Cardiovascular Medicine, General Hospital of Northern Theater Command, Shenyang 110016, China | hanyaling@263.netresidual | | XU Ying | Department of Cardiovascular Medicine, General Hospital of Northern Theater Command, Shenyang 110016, China | hanyaling@263.netresidual | | CAO Yi-Nan | Department of Cardiovascular Medicine, General Hospital of Northern Theater Command, Shenyang 110016, China | hanyaling@263.netresidual | | QIU Miao-Han | Department of Cardiovascular Medicine, General Hospital of Northern Theater Command, Shenyang 110016, China | hanyaling@263.netresidual | | LI Yi | Department of Cardiovascular Medicine, General Hospital of Northern Theater Command, Shenyang 110016, China | hanyaling@263.netresidual | | HAN Ya-Ling | Department of Cardiovascular Medicine, Second Affiliated Hospital of Harbin Medical University, Harbin 150086, China
Department of Cardiovascular Medicine, General Hospital of Northern Theater Command, Shenyang 110016, China | hanyaling@263.netresidual |
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| Abstract: |
| Objective To investigate the residual cardiovascular disease risk after smoking cessation in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). Methods The study was based on a large registry study Optimal Anti-platelet Therapy for Chinese patients with Coronary Artery Disease (OPT-CAD). ACS patients undergoing PCI in the OPT-CAD study from January 2012 to February 2014 were enrolled in the current study and were divided into three groups according to their smoking status (never, current smoking and smoking cessation for more than 1 year):non-smoker, smoker, and former smoker. The three groups were compared in the clinical data and characterizes of the interventional surgery, and the incidence of major adverse cardiovascular and cerebrovascular events (MACCE) in the five-year clinical follow-up visit. All data analysis was based on R language version 4.1.2, and 3 groups of propensity score matching were performed by the Trimatch package. Data comparison between two groups was perfomed using t test, Wilcoxon test or χ2test depending on data type. Cumulative event occurrence curves were drawn using the Kaplan-Meier method and compared between two groups by the log-rank test. Results The baseline characteristics of the three groups were essentially identical after propensity score matching. There was no significant difference in the incidence of 1- and 5-year MACCE between the three groups before the propensity score matching. After the propensity score matching, there was no significant difference in the incidence of 1-year MACCE among the three groups, but incidence of 1-year target vessel revascularization differed significantly among the smoker group, the former smoker group and the non-smoker group [28(3.7%) vs 24(3.2%) vs 12(1.6%),P<0.05], and the rate in the smoker group and former smoker group were higher than the non-smoker group. There were significant differences among the non-smoker group, the smoker group and the former smoker group in the incidence of 5-year MACCE, all-cause mortality, and target vessel revascularization [94(12.6%)vs 137(18.3%) vs 105(14.0%),48(6.4%) vs 85(11.4%) vs 59(7.9%),31(4.1%) vs 58(7.7%) vs 40(5.3%)；all P < 0.01]. The incidence of 5-year MACCE, all-cause mortality and target vessel revascularization in the smoker group were higher than those in the non-smoker group (all P< 0.05). The incidence of 5-year MACCE and 5-year target vascular revascularization in the three groups with different smoking status tended to differ over time (log-rank P<0.01). The risk of 5-year MACCE in the smoker group (HR=1.51,95%CI 1.16-1.96; P<0.05) and the former smoker group (HR=1.14,95%CI 0.87-1.50; P>0.05) were higher than that in the non-smoker group. The risk of 5-year target vascular revascularization in the smoker group (HR=1.96,95%CI 1.26-3.02; P<0.05) and the former smoker group (HR=1.33,95%CI 0.83-2.12; P>0.05) were higher than that in the non-smoker group. Conclusion Smoking is significantly associated with the risk of recurrence in cardiovascular disease. Smoking cessation reduces the incidence of MACCE events, but residual cardiovascular risk remains. |
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