title: Long-term effect of persistent smoking on the prognosis of Chinese male patients after percutaneous coronary intervention with drug-eluting stent implantation.
abstract: OBJECTIVE
  This study aimed to survey the adherence to smoking cessation and assess the influence of persistent smoking on the prognosis in male patients after drug-eluting stent (DES) implantation.
  
  
  METHODS
  The smoking status at the time of the index procedure and at follow-up was surveyed in 656 male patients undergoing successful percutaneous coronary intervention (PCI) with DES in our center. These patients were divided into three groups, based on their smoking status: nonsmokers (n=226), quitters (n=283), and persistent smokers (n=147). Major adverse cardiac and cerebrovascular events (MACCE) during the follow-up period were carefully recorded and their relationship with smoking status was investigated for 24-41 months.
  
  
  RESULTS
  Among 656 patients who were followed up for 27.24±6.33 (7-40) months, 430 of them were smokers (65.5%) at the index procedure. A total of 147 patients (22.4%) who continued to smoke, accounted for 34.2% of smokers at the time of PCI. Persistent smokers and quitters were more likely to be young (p<0.001) than nonsmokers, persistent smokers had more dyslipidemia (p=0.005), and fewer took aspirin (p=0.016) and statins (p=0.045) than quitters and nonsmokers. Weight gain was greater for quitters (p<0.016) than for nonsmokers. The incidence of all-cause death (6.1% v.s. 1.8% and 1.1%, p=0.004) and MACCE (15.0% vs 7.1% and 5.3%, p=0.002) in persistent smokers were significantly higher than those in nonsmokers and quitters. Multiple regression analysis showed that persistent smoking was a significantly determinant factor for all-cause death [hazard ratio (HR)=2.432, 95% confidence interval (CI) 1.170-5.054; p<0.017] and MACCE (HR=1.519, 95% CI 1.049-2.200; p=0.027).
  
  
  CONCLUSIONS
  This is the first follow-up report about the long-term effect of persistent smoking in Chinese male patients after DES implantation. Our findings strongly indicate that poor adherence to smoking cessation is a predictive factor for all-cause death and MACCE.
authors.affiliation: Department of Cardiology, Zhengzhou University People's Hospital, Zhengzhou, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Liu
authors.forename: Zhong-yu
authors.initials: ZY
authors.lastname: Zhu
authors.forename: Chuan-yu
authors.initials: CY
authors.lastname: Gao
authors.forename: Xian-pei
authors.initials: XP
authors.lastname: Wang
authors.forename: You
authors.initials: Y
authors.lastname: Zhang
authors.forename: Wei-dong
authors.initials: WD
authors.lastname: Jin
authors.forename: Da-tun
authors.initials: DT
authors.lastname: Qi
authors.forename: Mu-wei
authors.initials: MW
authors.lastname: Li
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D044466:Asian People; D002318:Cardiovascular Diseases / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D002423:Cause of Death; D002561:Cerebrovascular Disorders / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D002681:China / Q000453:epidemiology; D054855:Drug-Eluting Stents; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data*; D062645:Percutaneous Coronary Intervention / Q000379:methods / Q000401:mortality; D011379:Prognosis; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology*; D016540:Smoking Cessation / Q000706:statistics & numerical data; D013997:Time Factors
keywords: Coronary heart disease; Drug-eluting stent; Percutaneous coronary intervention; Prognosis; Smoking status