Author + information
- Min-Ho Lee,
- Chang-Hwan Yoon,
- Jin-Ju Park,
- Myung-Jin Cha,
- Sang-Don Park,
- Il-Young Oh,
- Jung-Won Suh,
- Young-Seok Cho,
- Tae-Jin Youn,
- Dong-Ju Choi and
- In-Ho Chae
Although exposure to cigarette smoke is known to be deleterious to patients with coronary heart disease, the impact of smoking status on the clinical outcomes in patients with recanalized chronic total occlusion (CTO) is not well established.
In the Korea Multicenter CTO registry, 26 centers enrolled 2608 patients who were successfully revascularized from January 2007 to December 2009. We classified the smoking status into smokers or nonsmokers. Nonsmokers were defined as patients who had never smoked cigarettes regularly and all other patients were considered smokers. Primary end point was major adverse cardiovascular events (MACE) defined as a composite of cardiac death (CD), nonfatal myocardial infarction (MI), and target lesion revascularization (TLR). Patients were followed up for clinical events and evaluated for development of MACE using medical record.
Among 2608 patients, 602 patients were excluded from the final analysis because of no information about smoking status (n=252) and follow-up status (n=350). Finally 2008 patients were included and classified into smokers (n=1053) or nonsmokers (n=953). In comparison to nonsmokers, smokers were younger, more often men, and less frequently had hypertension, diabetes. During median follow-up of 714 days, MACE and CD of smokers were not different from that of nonsmokers (9.2% vs. 7.9%, p=0.195; 1.4% vs. 1.7%, p=0.411). However, smokers presented with lower MI (0.3% vs. 1.2%, p=0.020) and higher TLR (8.7% vs. 6.4%, p=0.046). After multivariate correction for potential confounders, the rate of MI remained significantly lower (HR 0.264, 95%CI 0.073–0.961, p=0.043), and the rate of TLR remained significantly higher (HR 1.435, 95%CI 1.012-2.035, p=0.043) in smokers.
After successful CTO intervention, smoking status was not associated with risk for MACE. However, smokers were associated with a lower risk of subsequent MI and higher risk of subsequent TLR in both univariate and multivariate analysis. We should emphasize smoking cessation to patients with revascularized CTO with proper use of antiplatelet agents which should be further investigated.
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Acute Coronary Syndromes: Clinical Outcomes
Abstract Category: 1. Acute Coronary Syndromes: Clinical
Presentation Number: 1299-176
- 2013 American College of Cardiology Foundation