Abstract 16476: In Patients with Coronary Artery Disease, Does Smoking Status at One Year After an Angiogram Influence Long Term Survival?
Background: Smoking is an independent risk factor for coronary artery disease (CAD). However, uncertainty exists whether different management strategies (medical, CABG, PCI) influence 1-year smoking status, or if smoking status at 1-year influences long term survival.
Methods: The APPROACH registry (which captures data on all patients who underwent coronary angiogram in Alberta, Canada) was used, including data from 2003 to 2010. Self-reported smoking status was captured by questionnaire 1 year after angiogram. Two cohorts were examined: (1) 11334 patients who returned the 1 year follow-up questionnaire; and of those patients, (2) 4246 patients who are matched based on propensity score for management strategy. We used Kaplan-Meier and Cox regression for all-cause mortality and hazard ratio analysis to assess the association between management strategies and smoking rates at 1 year follow-up.
Results: 2584 (23%) patients were smokers at baseline, and 1208 (11%) were smokers at 1-year. In the propensity-matched cohort, self-reported smoking cessation rates at 1 year following angiogram was significantly higher among CABG patients (68%) than PCI (37%) or medically treated patients (47%; p<0.001). Non-smokers had a significantly higher long term survival rate compared with smokers in both CABG (88% vs. 77%, p<0.05) and PCI groups (94% vs. 91%, p<0.05), but not in medically managed patients (89% vs. 88%, p= 0.8). Smokers who reported smoking cessation at 1 year had a significantly higher long term survival rate compared with those who kept smoking after CABG (94% vs. 77%, p<0.05), but not in medically managed (93% vs. 88%, p=0.16), or PCI patients (95% vs. 91%, p=0.10).
Conclusion: In patients treated for CAD, quitting smoking after an angiogram is associated with higher long term survival. All patients with CAD, particularly those undergoing PCI or medical management should be aggressively targeted for smoking cessation programmes to increase their quitting rates.
- © 2012 by American Heart Association, Inc.