title: Impact of smoking status on cardiovascular outcomes following percutaneous coronary intervention.
abstract: BACKGROUND
  Many military veterans in the United States with coronary artery disease continue to smoke despite undergoing percutaneous coronary intervention (PCI). Previous studies have described improved cardiovascular outcomes in smokers, the so-called "smokers' paradox." In this study, we examined the effects of smoking on cardiovascular outcomes following PCI.
  
  
  OBJECTIVE
  Do patients who smoke have different post-PCI outcomes than nonsmokers?
  
  
  METHODS
  All patients who underwent PCI at a single US Veterans Administration hospital from 2004 to 2009 were followed. Outcomes of interest included myocardial infarction, unplanned coronary intervention, unplanned cardiac hospitalization, death, and a composite of events for 6 months after PCI. Changes in traditional risk factors were also assessed.
  
  
  RESULTS
  Unadjusted analysis revealed that in almost all categories, smokers had lower incidence of adverse events than nonsmokers. However, after adjusting for the older age of the nonsmokers, no favorable statistical trend toward smokers was seen. Significant improvement in blood pressure and lipid levels were seen in both groups.
  
  
  CONCLUSIONS
  After adjusting for differences in age, there did not appear to be any protective effect of smoking on cardiovascular outcomes following PCI. Smokers achieved similar degrees of risk factor optimization during the follow-up period as their nonsmoker counterparts. Aggressive efforts to decrease the prevalence of smoking must be maintained.
authors.affiliation: Division of Cardiology, University of Illinois Hospitals and Health Sciences System, Jesse Brown VA Medical Center, Chicago, IL, USA.
authors.forename: Burhan
authors.initials: B
authors.lastname: Mohamedali
authors.forename: Adhir
authors.initials: A
authors.lastname: Shroff
mesh_terms: D000367:Age Factors; D000368:Aged; D016009:Chi-Square Distribution; D002641:Chicago / Q000453:epidemiology; D005260:Female; D006760:Hospitalization; D006787:Hospitals, Veterans; D006801:Humans; D015994:Incidence; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000453:epidemiology; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D016540:Smoking Cessation; D000074606:Smoking Prevention; D013997:Time Factors; D016896:Treatment Outcome