Impact of smoking status on long-term mortality in patients with acute myocardial infarction

  • Kinjo K
  • Sato H
  • Sakata Y
 et al. 
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BACKGROUND: Cessation of smoking after a cardiovascular event has been shown in Western countries to have a beneficial effect on clinical events during long-term follow-up. However, knowledge of the effect of smoking status after acute myocardial infarction (AMI) on the long-term mortality based on a large-scale sample is still limited in Japan. METHODS AND RESULTS: In the present study 2,579 AMI patients were enrolled in the Osaka Acute Coronary Insufficiency Study (OACIS) between April 1998 and March 2003. Smoking status was assessed at baseline and 3 months after hospital discharge by mailed questionnaire. Patients were divided into nonsmokers (n=823), former smokers (those who had stopped smoking before AMI onset, n=332), quitters (those who stopped smoking after AMI onset, n=1,056), and persistent smokers (those who smoked before and after AMI, n=368). Quitters had lower long-term mortality rates than persistent smokers (3.0% vs 5.2%; log rank, p=0.032). Multivariate Cox regression analysis revealed that smoking cessation was independently associated with a reduction in risk of long-term mortality (hazard ratio, 0.39; 95% confidence interval, 0.20-0.77). CONCLUSIONS: Patients who continue to smoke after AMI are at greater risk for death than patients who quit smoking. Cessation of smoking benefits the long-term prognosis in patients with AMI.

Author-supplied keywords

  • Angina Pectoris/epidemiology
  • Coronary Artery Disease/epidemiology/surgery/thera
  • Diabetes Mellitus/epidemiology
  • Female
  • Humans
  • Hyperlipidemias/epidemiology
  • Hypertension/epidemiology
  • Japan/epidemiology
  • Male
  • Middle Aged
  • Myocardial Infarction/*mortality
  • Risk Factors
  • Smoking/*epidemiology
  • Survival Analysis

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  • K Kinjo

  • H Sato

  • Y Sakata

  • D Nakatani

  • H Mizuno

  • M Shimizu

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