Current Smoking, Smoking Cessation, and the Risk of Sudden Cardiac Death in Patients With Coronary Artery Disease
Abstract
BACKGROUND: Cigarette smoking is a known risk factor for sudden cardiac death (SCD). However, the effect of continued cigarette smoking and smoking cessation on SCD risk in patients with established coronary artery disease (CAD) is subject to controversy. We, therefore, evaluated the effect of cigarette smoking on SCD risk in a large cohort of patients with established CAD. METHODS: The study population was composed of 3122 patients with a previous myocardial infarction or stable angina who participated in the Bezafibrate Infarction Prevention Trial. Patients were prospectively followed up for a mean of 8.2 years. The primary end point was the incidence of SCD according to smoking status. RESULTS: Among the 370 patients who were current smokers, 30 (8.1%) experienced SCD; 83 (4.6%) of the 1821 patients who had quit smoking and 43 (4.6%) of the 931 patients who had never smoked experienced SCD (P =.01). In multivariate analyses, current smoking was associated with a significant increase in the risk of SCD (hazard ratio, 2.47; 95% confidence interval, 1.46-4.19). Patients who had stopped smoking had no significant increase in the risk of SCD compared with patients who had never smoked (hazard ratio, 1.06; 95% confidence interval, 0.70-1.62). CONCLUSIONS: Current cigarette smoking is a powerful independent predictor of SCD risk in patients with CAD. Patients who quit smoking experienced a significant reduction in SCD risk. Thus, efforts to reduce mortality from SCD in patients with CAD should include vigorous smoking cessation strategies.
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In a study where patients who underwent PCI were followed up for a long period, the relative risk for cardiovascular events in those with metabolic syndrome was 2.1-fold higher.
“In a study where patients who underwent PCI were followed up with for a long period, the relative risk for cardiovascular events in those with metabolic syndrome was 2.1-fold higher777).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [777]
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- Authors
- Goldenberg, I.
- Affiliations
- Sheba Medical Center (IL)
- Corresponding author
- Goldenberg, Ilan
- ORCID
- Goldenberg, Ilan
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2003-10-27
- Volume
- 163
- Issue
- 19
- Pages
- 2301
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W2092685152
- Cited by
- 178
- References
- 29
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 11 · 2023: 7 · 2022: 11 · 2021: 3 · 2020: 3 · 2019: 5 · 2018: 5 · 2017: 5 · 2016: 6 · 2015: 15 · 2014: 8 · 2013: 9 · 2012: 11
- FWCI
- 3.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Keywords
- sudden cardiac death, cigarette smoking, smoking cessation, coronary artery disease, myocardial infarction, stable angina, smoking as risk factor, mortality reduction
- MeSH terms
- Aged, Coronary Artery Disease, Female, Humans, Male, Middle Aged, Risk Factors, Multivariate Analysis, Proportional Hazards Models, Randomized Controlled Trials as Topic, Smoking Cessation, Risk Assessment
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