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Cited by 64Lipoproteins and Cardiovascular HealthSmoking Behavior and CessationAcute Myocardial Infarction Research

Impact of Smoking on Cardiovascular Events in Patients With Coronary Disease Receiving Contemporary Medical Therapy (from the Treating to New Targets [TNT] and the Incremental Decrease in End Points Through Aggressive Lipid Lowering [IDEAL] Trials)

Frey, Paul, Waters, David D., DeMicco, David A., Breazna, Andrei, Samuels, Larry, Pipe, Andrew, Wun, Chuan-Chuan, Benowitz, Neal L.·2011·The American Journal of Cardiology
DOI 10.1016/j.amjcard.2010.09.006
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Abstract

To define the incremental risk of cigarette smoking in patients with coronary disease receiving contemporary medical therapy, we performed a post hoc analysis of 18,885 patients by combining data from the Treating to New Targets (TNT) and the Incremental Decrease in End Points through Aggressive Lipid Lowering (IDEAL) trials. These studies compared high-dose treatment (atorvastatin 80 mg/day) to moderate-dose treatment (atorvastatin 10 mg/day in TNT and simvastatin 20 to 40 mg/day in IDEAL) in patients with established coronary heart disease. The primary end point of this pooled analysis was major cardiovascular events, a composite of cardiac death, myocardial infarction, stroke, or resuscitated cardiac arrest. At baseline 4,196 patients had never smoked, 11,513 were ex-smokers, and 3,176 were current smokers. The adjusted hazard ratio for current smokers compared to never smokers was 1.68 (95% confidence interval 1.46 to 1.94) and that for current smokers compared to ex-smokers was 1.57 (95% confidence interval 1.41 to 1.76). Event rates for current smokers compared to ex-smokers were similarly increased in each treatment group. The difference in absolute event rates between current and ex-smokers in this pooled analysis was 4.5%, which is >2 times as large as the decrease in absolute event rates between high-dose and moderate-dose statin therapy found in the IDEAL (1.7%) and TNT (2.2%) trials, respectively. In conclusion, in patients with coronary disease receiving modern medical therapy, smoking cessation is of substantial benefit with a number needed to treat of 22 to prevent a major cardiovascular event over 5 years. Smoking cessation deserves greater emphasis in secondary prevention.

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Crossref · 10.1016/j.amjcard.2010.09.006

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33 of 33 references verified0 citation errors · 0 not checkable

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  • Compared to those who continued smoking, the total mortality risk of patients who quit smoking decreased significantly by 61%.

    “Compared to those who continued smoking, the total mortality risk of patients who quitted smoking decreased significantly by 61%785).”

    From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [785]

  • Many epidemiological studies have reported that regardless of age and gender, the risk of recurrence of cardiovascular events decreases by approximately half after the first year of smoking cessation and continues to decrease thereafter.

    “Many epidemiological studies have reported that regardless of age and gender, the risk of recurrence of cardiovascular events decreases by approximately half after the first year of smoking cessation and continue to decrease thereafter.”

    From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [785]

  • In the OACIS study, the total mortality risk in patients who quit smoking after myocardial infarction decreased to the same level as nonsmokers.

    “In contrast, the total mortality risk in patients who quitted smoking after myocardial infarction incidence decreased to the same level as the nonsmokers.”

    From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [785]

  • In the OACIS study, after adjusting for age, gender, DM, hypertension, dyslipidemia, and therapeutic agents, the risk for total mortality in post-myocardial infarction patients who continued smoking was 2.3-fold higher than in lifelong nonsmokers.

    “In the OACIS study, even after adjusting for age, gender, DM, hypertension, dyslipidemia, and therapeutic agents, the risk for total mortality in post-myocardial infarction patients who continued smoking was 2.3-fold higher than in lifelong nonsmokers.”

    From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [785]

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Authors
Frey, P., Waters, D. D., DeMicco, D. A., Breazna, A., Samuels, L., Pipe, A., Wun, C.-C., & Benowitz, N. L.
Affiliations
  • University of California, San Francisco (US)
  • Pfizer (United States) (US)
  • Ottawa Heart Institute (CA)
Corresponding author
Waters, David D.
ORCID
Venue
The American Journal of Cardiology
Publisher
Elsevier BV
Published
2011-01
Volume
107
Issue
2
Pages
145-150
ISSN
0002-9149 (ISSN-L)
DOI
10.1016/j.amjcard.2010.09.006
OpenAlex
W1981655248
Cited by
64
References
33
Citations by year
2026: 2 · 2025: 1 · 2022: 4 · 2021: 1 · 2020: 3 · 2019: 5 · 2018: 3 · 2017: 5 · 2016: 7 · 2015: 2 · 2014: 5 · 2013: 8 · 2012: 10
FWCI
8.78
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The American Journal of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
Keywords
cigarette smoking, coronary artery disease, major adverse cardiovascular events, smoking cessation, statin therapy, atorvastatin, simvastatin, high-intensity statin therapy, former smokers, secondary prevention, IDEAL trial
MeSH terms
Atorvastatin, Adult, Aged, Anticholesteremic Agents, Coronary Disease, Dose-Response Relationship, Drug, Double-Blind Method, Female, Follow-Up Studies, Heart Rate, Heptanoic Acids, Humans, Cholesterol, LDL, Male, Middle Aged, Prospective Studies, Pyrroles, Risk Factors, Smoking, United States, Survival Rate, Treatment Outcome, Disease Progression, Simvastatin

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