title: Impact of smoking status on long-term mortality in patients with acute myocardial infarction.
abstract: 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.
  
  
  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.
authors.affiliation: Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine, Suita, Japan.
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Kinjo
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sato
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Sakata
authors.forename: Daisaku
authors.initials: D
authors.lastname: Nakatani
authors.forename: Hiroya
authors.initials: H
authors.lastname: Mizuno
authors.forename: Masahiko
authors.initials: M
authors.lastname: Shimizu
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Sasaki
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Kijima
authors.forename: Masami
authors.initials: M
authors.lastname: Nishino
authors.forename: Masaaki
authors.initials: M
authors.lastname: Uematsu
authors.forename: Jun
authors.initials: J
authors.lastname: Tanouchi
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Nanto
authors.forename: Kinya
authors.initials: K
authors.lastname: Otsu
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Hori
mesh_terms: D000787:Angina Pectoris / Q000453:epidemiology; D003324:Coronary Artery Disease / Q000453:epidemiology / Q000601:surgery / Q000628:therapy; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality*; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D016019:Survival Analysis