title: Comparison of Various Strategies for the Prognosis and Outcomes of Ischaemic Dilated Cardiomyopathy in Smokers: Complete Revascularisation and Smoking Cessation Produces a Superior Outcome.
abstract: BACKGROUND
  Various therapies have been used to improve the symptoms and prognosis of patients with coronary artery disease. However, comparative studies showing more suitable choices for patients with ischaemic dilated cardiomyopathy (IDCM) and who smoke cigarettes are lacking.
  
  
  METHODS
  A total of 338 patients were divided into four groups according to whether they received complete revascularisation (CR), and/or underwent smoking cessation (SC). They were followed prospectively for 12 months. The major adverse cardiac and cerebrovascular events (MACCEs: all-cause mortality, non-fatal MI, non-fatal stroke, repeat revascularisation, and AHF) were the primary endpoint, and decompensation necessitating hospitalisation and the combined endpoint thereof were secondary endpoints.
  
  
  RESULTS
  During a mean follow-up of 12 months, the prevalence of MACCEs was significantly lower in patients receiving CR plus SC (CRSC) than in patients receiving CR only (CR), SC only (SC), and neither R nor SC (NoRSC) (CRSC 4.4% vs. CR 11.9, p<0.05; vs. SC 26.5%, p<0.001; vs. NoRSC 34.5%, p<0.001, respectively). At 12 months, CR plus SC induced the greatest clinical benefits of the secondary outcomes in the CRSC group (49.1% relative increase in LVEF; 89.8% decrease in NT-proBNP level; 30.9% decrease in LVEDD; 38.3% decrease in LVESD; 51.4% decrease in LVEDVi; 51.2% decrease in LVESVi; 96.4% decrease in hs-cTnT level; 93.5% decrease in CK-MB level; 91.1% decrease in hs-CRP level; 94.0% decrease in IL-6 level; 1.9-fold increase in eNOS level; 1.8-fold increase in NO level; 1.3-fold increase in NOS level, all p<0.001). Absence of revascularisation brought about fewer benefits, and those who continued smoking had worse outcomes.
  
  
  CONCLUSIONS
  The combination of CR and SC could be an optimal therapeutic regimen for patients with IDCM who smoke because it improves myocardial blood perfusion and endothelial function.
authors.affiliation: Department of Cardiology, Geriatric Department, Yangpu Hospital, Tongji University School of Medicine, Shanghai 200090, PR China.
authors.forename: Jiahong
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Cardiology, Dahua Hospital, Xuhui District, Shanghai 200237, China.
authors.forename: Lan
authors.initials: L
authors.lastname: Zhao
authors.affiliation: Guangzhou Red Cross Hospital, Haizhu District, Guangzhou 510220, China.
authors.forename: Jiarui
authors.initials: J
authors.lastname: Wei
authors.affiliation: Department of Cardiology, Geriatric Department, Yangpu Hospital, Tongji University School of Medicine, Shanghai 200090, PR China; Department of Cardiology, the Third Affiliated Hospital of Southern Medical University, Tianhe District, Guangzhou, 510630. Electronic address: shaohengzh67@163.com.
authors.forename: Shaoheng
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Department of Cardiology, Geriatric Department, Yangpu Hospital, Tongji University School of Medicine, Shanghai 200090, PR China.
authors.forename: Nannan
authors.initials: N
authors.lastname: Chen
authors.affiliation: Department of Cardiology, Geriatric Department, Yangpu Hospital, Tongji University School of Medicine, Shanghai 200090, PR China.
authors.forename: Dongxing
authors.initials: D
authors.lastname: Ding
authors.affiliation: Department of Cardiology, Geriatric Department, Yangpu Hospital, Tongji University School of Medicine, Shanghai 200090, PR China.
authors.forename: Qunlin
authors.initials: Q
authors.lastname: Gong
authors.affiliation: Department of Cardiology, Geriatric Department, Yangpu Hospital, Tongji University School of Medicine, Shanghai 200090, PR China.
authors.forename: Feng
authors.initials: F
authors.lastname: Su
authors.affiliation: Department of Cardiology, Dahua Hospital, Xuhui District, Shanghai 200237, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Yan
authors.affiliation: Department of Cardiology, Geriatric Department, Yangpu Hospital, Tongji University School of Medicine, Shanghai 200090, PR China. Electronic address: guohongpei@sina.com.
authors.forename: Pengxiang
authors.initials: P
authors.lastname: Zheng
mesh_terms: D000368:Aged; D002311:Cardiomyopathy, Dilated / Q000503:physiopathology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization; D012907:Smoking / Q000503:physiopathology / Q000628:therapy; D016540:Smoking Cessation
keywords: Ischaemic dilated cardiomyopathy; Outcomes; Prognosis; Revascularisation; Smoking cessation