Abstract 13982: Impact of Persistent Smoking on Long-Term Outcomes Including Bleeding Events in Patients with Nonvalvular Atrial Fibrillation
Background: Although smoking is a risk factor for cardiovascular (CV) disease, little is known about the impact of smoking status on long-term outcomes including bleeding events in patients with atrial fibrillation (AF) during antithrombotic therapy.
Methods: In 498 patients with nonvalvular AF (mean age 66 years, 307 men, mean follow-up 5.8±3.2 years), clinical variables (e.g. smoking status, CHADS2 and CHA2DS2-VASc score), incidences of CV events (stroke and cardiac events (myocardial infarction or admission for heart failure)), bleeding and mortality were evaluated.
Results: The incidences of cerebral bleeding (0.7 vs 0.1%/years, p<0.01), all-cause mortality (4.9 vs 2.6%/years, p<0.01), death from malignant diseases (1.6 vs 0.5%/years, p<0.05), and ischemic heart disease (0.4 vs 0.1%/years) were higher in smokers than in those of non-smokers. In persistent smokers, the incidence of CV death was higher than in that of non-smokers (2.4 vs 1.2%/years). Previous smoking, independently of age, antithrombotic treatment, CHADS2 or CHA2DS2-VASc score, predicted all-cause mortality (Hazard ratio (HR) 2.7, p<0.01), death from stroke (HR 4.7, p<0.05) or death from malignant diseases (HR 2.8, p<0.05). Persistent smoking, independently of age or antithrombotic treatment, predicted cerebral bleeding (HR 4.6, p<0.05).
Conclusions: Smoking status, independently of age, antithrombotic treatment, or clinical risk factors, predicted long-term adverse outcomes including bleeding events in patients with nonvalvular AF. There might be a prove impact of persistent smoking on cerebral bleeding.
- © 2012 by American Heart Association, Inc.