Attenuated physical exercise capacity in smokers compared with non-smokers after coronary angioplasty despite similar luminal diameters.
OBJECTIVE
To study the impact of smoking on the change in exercise capacity in patients treated with coronary angioplasty.


METHODS
Three hundred and sixty-eight men below 70 years of age eligible for percutaneous transluminal coronary angioplasty without previous coronary interventions were consecutively enrolled. Of the 334 patients (90.8%) who completed the study 77 (23.1%) were current smokers. Exercise tests were performed before percutaneous transluminal coronary angioplasty, 2 and 19 +/- 2.4 weeks after percutaneous transluminal coronary angioplasty. Coronary angiography was done in 333 patients (99.7%) (at mean 19 +/- 2.4 weeks). The angiograms were analysed quantitatively.


RESULTS
There were no differences in the clinical and angiographic characteristics among the groups except for age. The non-smokers were older than the smokers (55.7 vs 52.4 years (P = 0.001)). Exercise capacity was equal before percutaneous transluminal coronary angioplasty in both groups (17.6 vs 16.5 W x min-1 x kg-1). Non-smokers had a significantly higher increase in exercise capacity than smokers from baseline to 2 weeks after percutaneous transluminal coronary angioplasty (mean difference 4.3 W x min-1 x kg-1 (95% CI: 2.3 to 6.2; P < 0.001)), and from baseline to 19 weeks after percutaneous transluminal coronary angioplasty (mean difference 3.9 W x min-1 x kg-1 (95% CI: 1.6 to 6.2; P < 0.001).


CONCLUSIONS
A clinical benefit from percutaneous transluminal coronary angioplasty was seen in both groups as judged from exercise testing. Smokers had a substantially lower increase in exercise capacity than non-smokers, indicating an attenuated benefit from percutaneous transluminal coronary angioplasty among smokers.
Department of Cardiology, University of Oslo, Norway.
B
B
Jørgensen
K
K
Endresen
K
K
Forfang
S
S
Simonsen
E
E
Thaulow
D000328:Adult; D000368:Aged; D017311:Amlodipine / Q000008:administration & dosage; D015906:Angioplasty, Balloon, Coronary; D003131:Combined Modality Therapy; D017023:Coronary Angiography; D003327:Coronary Disease / Q000503:physiopathology / Q000628:therapy*; D005080:Exercise Test; D006801:Humans; D008297:Male; D008875:Middle Aged; D010807:Physical Endurance / Q000502:physiology; D012907:Smoking / Q000009:adverse effects* / Q000503:physiopathology; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage
D014665:Vasodilator Agents; D017311:Amlodipine