Curriculum in CardiologyInpatient smoking-cessation counseling and all-cause mortality in patients with acute myocardial infarction
Section snippets
Study design
This study was a retrospective analysis of patients presenting with AMI at 83 teaching and community hospitals (103 sites) in Ontario, Canada, between April 1, 1999, and March 31, 2001. The patient population was derived from the EFFECT study, a large initiative to improve the quality of AMI care in Ontario.12 We identified newly admitted patients with a most responsible diagnosis (ie, the principal diagnosis which accounts for most of a patient's length of stay) of AMI using the Canadian
Study population and baseline characteristics
Among the 11 524 patients with AMI in the EFFECT database, 2483 were excluded for prespecified reasons (Figure 1). Thus, 9041 patients who were admitted with an AMI and discharged alive were included in this study.
Table I shows the baseline characteristics of the study population. Of the 9041 patients, 67.1% were male and 32.9% were female. There was no significant difference in the proportion of patients with STEMI and NSTEMI. Among patients admitted with AMI, 67.4% had a history of smoking and
Discussion
Patients who continue to smoke after a diagnosis of coronary artery disease or AMI are at greater risk for death than those who quit smoking.4, 7, 17 This is likely because of the association of cigarette smoking with increased thrombosis, cytokine production, endothelial dysfunction, coronary vasoreactivity, arrhythmogenesis, and sudden cardiac death.5, 6, 18, 19, 20, 21 According to one systematic review, smoking cessation is associated with a relative risk of 0.64 of all-cause mortality
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Cited by (61)
ST-segment elevation acute myocardial infarction in young people: influence of age in the smoke paradox
2020, REC: CardioClinicsCitation Excerpt :Outcomes after single percutaneous transluminal coronary angioplasty and coronary artery bypass grafting are better when tobacco cessation is achieved.20,37,38 Thus, smoking cessation significantly reduces long-term mortality, and counseling to quit smoking is an underused, very effective and costless intervention to improve long-term survival,39,40 even in older patients.41 In fact, Pell et al. reported that the number of admission for acute coronary syndrome decreased after implementing smoke-free legislation in the United Kingdom.42
Cardiac rehabilitation in the acute care setting: Integrative review
2017, Australian Critical CareCitation Excerpt :Further, that the amount of information that patients receive is directly related to patients’ satisfaction with health care [32]. Many studies identified that the depth of staff knowledgein the area Phase one CR delivery was important [26–30,33–38]. Kilonzo and O’Connell [33] reported that cardiac nurses differed not only in their perception of patients learning needs but also in their perceptions of their own value as educators.
Life Years Gained From Smoking-Cessation Counseling After Myocardial Infarction
2017, American Journal of Preventive MedicineTreatment and outcomes of non-ST elevation acute coronary syndromes in relation to burden of pre-existing vascular disease
2013, International Journal of CardiologyCitation Excerpt :There may also be a greater rate of hospitalization and therefore greater opportunity for smoking cessation intervention. Finally, there may be a survivor bias in patients with more vascular disease who stop smoking [18–21]. Previous studies [7,10,11,17] of vascular disease patients admitted for ACS have shown less utilization of coronary angiography.
The EFFECT study is funded by a Canadian Institutes of Health Research Team Grant in Cardiovascular Outcomes Research. Additional funding for this project came from an operating grant (Grant No. NA 5703) from the Heart and Stroke Foundation of Ontario. Dr Tu is funded by a Canada Research Chair in Health Services Research and a Career Investigator Award from the Heart and Stroke Foundation of Ontario.