Impact of smoking status on long-term mortality in patients with acute myocardial infarction.
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.
Kinjo
Kunihiro
K
Department of Internal Medicine and Therapeutics, Osaka University Graduate School of Medicine, Suita, Japan.
Sato
Hiroshi
H
Sakata
Yasuhiko
Y
Nakatani
Daisaku
D
Mizuno
Hiroya
H
Shimizu
Masahiko
M
Sasaki
Tatsuya
T
Kijima
Yoshiyuki
Y
Nishino
Masami
M
Uematsu
Masaaki
M
Tanouchi
Jun
J
Nanto
Shinsuke
S
Otsu
Kinya
K
Hori
Masatsugu
M
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