Abstract 16460: Differential Impact Of Cigarette Smoking On Prognosis In Women Compared With Men With Coronary Artery Disease Undergoing Percutaneous Coronary Intervention
Background: Cigarette smoking is an important risk factor for worse outcomes in patients with coronary artery disease. Whether smoking confers the same excess risk for women versus men is not known. Therefore, we sought to investigate the effect of cigarette smoking on clinical outcomes in women versus men with coronary artery disease undergoing elective percutaneous coronary intervention (PCI) after adjusting for other risk factors.
Methods: We prospectively followed up a total of 10,462 patients undergoing elective PCI between January, 2013 and June, 2014 in our cardiovascular center. All the patients were stratified according to smoking status and sex. The impact of cigarette smoking on long-term all-cause death and the interaction between the effect of smoking on death and sex were evaluated by Cox regression model taking smoking status as a time-varying variable.
Results: Among 6,482 men and 3,980 women undergoing PCI, the prevalence of cigarette smoking was 42.5% (n = 2754) and 10.4% (n = 412) respectively at baseline (p < 0.001). During the 3 years of follow-up (median 18.6 months), 1,321 men (48.0%) and 126 women (30.6%) quitted smoking (p < 0.001). After adjusting for baseline characteristics, cigarette smoking was an independent risk factor of death in women (HR 3.26, 95% CI 2.13 to 4.99), but not in men (HR 1.38, 95% CI 0.92 to 2.07) (p value for interaction = 0.032).
Conclusion: Despite a low prevalence of smoking in women versus men among patients undergoing PCI, quitting smoking is more challenging in women. Smoking confers a higher excess risk of all-cause death among women compared with men.
Author Disclosures: L. Yang: None. Z. Wang: None.
- © 2016 by American Heart Association, Inc.