Impact of smoking and smoking cession on long-term outcome of patients after coronary artery bypass grafting
10.3760/cma.j.issn.0253-3758.2011.09.011
- VernacularTitle:吸烟和戒烟对冠状动脉旁路移植术后远期结果的影响
- Author:
Hai-Ning SUN
1
;
Sheng-Shou HU
;
Zhe ZHENG
;
Jian-Feng HOU
Author Information
1. 中国医学科学院北京协和医学院阜外心血管病医院
- Keywords:
Cardiovascular surgical procedures;
Smoking;
Treatment outcome
- From:
Chinese Journal of Cardiology
2011;39(9):825-829
- CountryChina
- Language:Chinese
-
Abstract:
Objective To determine the impact of smoking behaviors on long-term outcomes of coronary artery bypass grafting (CABG). Methods We conducted this survey in 2541 consecutive patients who underwent CABG in Fu Wai hospital from January 1, 2004 to December 30, 2005. The preoperative and postoperative smoking habits were obtained. The patients were divided into never smokers and ever smokers. The ever smokers were further divided into the current smokers who smoked before and after CABG and former smokers who stopped smoking before CABG, quitters who stopped smoking after CABG. Death,major adverse cardiovascular or cerebrovascular events and angina pectoris were observed. The relative risk of adverse events in different patients were analyzed by univariate and multivariate Cox analysis. Results The patients were followed up for 4. 27 to 6. 41 years ( average 5.09 years ). After CABG, the percentage of persistent smoking patients was 22. 1％. After adjusting baseline characteristics, relative risk for tumor related death ( RR:2. 38,95％ CI: 1.06 - 5. 36 ), major adverse cardiovascular or cerebrovascular events (RR:1.26, 95％ CI: 1.01 - 1.57) and angina pectoris (RR: 1.29, 95％ CI: 1.04 -1.59) were significantly higher in ever smokers than in never smokers. Similarly, relative risk of death from all causes ( RR :2.60, 95 ％ CI: 1.53 - 4. 46), cardiac death ( RR: 2. 51, 95 ％ CI: 1.32 - 4. 78 ), tumor cause death ( RR :5. 12, 95 ％ CI: 2. 08 - 12. 59 ), major adverse cardiovascular or cerebrovascular events ( RR: 1.83,95％ CI: 1.42 - 2. 34) and angina pectoris ( RR: 1.69, 95％ CI: 1.33 - 2. 16) were also significantly higher in current smokers than in never smokers. Outcome was similar between patients who stopped smoking and never smokers(all P ＞0. 05). Conclusions Smoking prevalence is still high in patients after CABG in China. Persistent smoking is associated with higher rates of mortality and morbidity after CABG while smoking cession is associated with reduction of morbidity and mortality in patients after CABG.
