[Progression of coronary sclerosis after smoking cessation].
Cigarette smoking is an established risk factor for the development of coronary artery disease, but whether cessation of heavy smoking influences progression of coronary artery disease is unclear. In 390 patients (359 men, 31 women; 52.4 +/- 6.7 SD years) with coronary artery disease, two coronary angiograms were performed at an interval of 62.4 +/- 23.5 months. Smoking habits were obtained by questionnaires. Progression of coronary artery disease was defined as the sum of new stenoses, progression of existing stenoses and new coronary occlusions. Multivariate classification analyses of risk factor profile revealed cigarette smoking (amount per day and length of time) as the most relevant factor for progression of coronary artery disease. Non-smokers had a progression score of 0.96 (95% confidence interval: 0.63-1.28) over the observation period. Former smokers (20.2 +/- 11.8 cigarettes/day for 19.4 +/- 7.6 years) who quit about 10 years before the first angiogram showed a progression of 2.20 (95% confidence interval: 1.77-2.63; p < 0.01) compared to non-smokers. Those smokers (23.8 +/- 9.2 cigarettes/day for 31.3 +/- 7.0 years) who quit at the time of the first angiogram showed a progression of 2.47 (95% confidence interval: 1.97-2.97; p < 0.001). Current smokers (20.5 +/- 9.7 cigarettes/day for 34.8 +/- 8.5 years) had a progression of 3.17 (95% confidence interval: 2.35-3.99; p < 0.001). The data indicate that former heavy cigarette smoking continues to act as a significant risk factor for progression of coronary artery disease even after cessation. This does not mean that current cigarette smokers should not stop.(ABSTRACT TRUNCATED AT 250 WORDS)
Wenzlaff
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Abteilung Kardiologie, Medizinische Hochschule Hannover.
Amende
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D000328:Adult; D000368:Aged; D016001:Confidence Intervals; D017023:Coronary Angiography / Q000706:statistics & numerical data; D003324:Coronary Artery Disease / Q000145:classification / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D016540:Smoking Cessation
Progression der Koronarsklerose nach Einstellen des Zigarettenrauchens.