title: Changes in smoking behavior and adherence to preventive guidelines among smokers after a heart attack.
abstract: OBJECTIVE
  Risk factor modification is key to preventing subsequent cardiac events after a heart attack. This study was designed to investigate the disparity between preventive guidelines and clinical practice among smoking patients.
  
  
  METHODS
  The study was carried out in smokers admitted with myocardial infarction (MI). A total of 275 patients who had been regularly followed for over one year after MI were randomly selected and enrolled in this study. We investigated changes in smoking behavior and the adherence rate to ACC/AHA Guidelines for secondary prevention in patients with coronary artery disease at the time of, and one year after, the index event.
  
  
  RESULTS
  The study population consisted of 275 patients (97.1% males) with a mean age of 57.0 ± 11.2 years. Achievement of target goals at one year was as follows: smoking cessation, 52.3%; blood pressure, 83.9%; HbA1c, 32.7%; lipid profile, 65.5%; and body mass index (BMI), 50.6%. Over one year, 80% of the patients attempted to quit smoking; 27% of them re-started smoking within one month after discharge while 65% succeeded in cessation of smoking. At one year, only 52% of the patients overall had stopped smoking. From the multivariate logistic analysis including smoking patterns and clinical characteristics, the severity of coronary artery disease was the only independent predictor for smoking cessation (Relative risk (RR): 1.230; P = 0.022).
  
  
  CONCLUSIONS
  Only a small percentage of MI patients adhere to guidelines for secondary prevention and a sizable proportion fail to stop smoking. These findings underscore the need for an effective patient education system.
authors.affiliation: Divison of Cardiology, Department of Internal Medicine, Yeungnam University Hospital, 170, Hyeonchung-ro, Nam-gu, Daegu 705-717, South Korea.
authors.forename: Yoon-Jung
authors.initials: YJ
authors.lastname: Choi
authors.forename: Jong-Seon
authors.initials: JS
authors.lastname: Park
authors.forename: Ung
authors.initials: U
authors.lastname: Kim
authors.forename: Sang-Hee
authors.initials: SH
authors.lastname: Lee
authors.forename: Jang-Won
authors.initials: JW
authors.lastname: Son
authors.forename: Dong-Gu
authors.initials: DG
authors.lastname: Shin
authors.forename: Young-Jo
authors.initials: YJ
authors.lastname: Kim
authors.forename: Myung-Ho
authors.initials: MH
authors.lastname: Jeong
authors.forename: Young-Keun
authors.initials: YK
authors.lastname: Ahn
authors.forename: Myeong-Chan
authors.initials: MC
authors.lastname: Cho
authors.forename: Jang-Whan
authors.initials: JW
authors.lastname: Bae
authors.forename: Chong-Jin
authors.initials: CJ
authors.lastname: Kim
authors.forename: Jin-Man
authors.initials: JM
authors.lastname: Cho
authors.forename: Kyoo-Rok
authors.initials: KR
authors.lastname: Han
authors.forename: Jun-Hee
authors.initials: JH
authors.lastname: Lee
keywords: Coronary artery disease; Myocardial infarction; Prevention; Smoking