Survival Benefit of Smoking Cessation High After MI

For smokers with LV dysfunction after MI, quitting decreases mortality risk more than some drugs

WEDNESDAY, Nov. 3 (HealthDay News) -- Smoking cessation after myocardial infarction (MI) resulting in left ventricular (LV) dysfunction lowers all-cause mortality risk more than many pharmacologic interventions, according to a study in the Oct. 1 issue of the American Journal of Cardiology.

Amil M. Shah, M.D., of Brigham and Women's Hospital in Boston, and colleagues conducted a randomized trial of 2,231 subjects with LV dysfunction three to 16 days after MI. Smoking status was assessed at trial entry and at regular intervals over a median 42-month follow-up. The purpose of the study was to assess the benefit of smoking cessation versus continued smoking in this population at high risk for death and recurrent MI.

The researchers found that, in subjects who smoked at baseline and survived to six months without interval cardiac events, smoking cessation at six-month follow-up was associated with a significantly lower all-cause mortality risk (hazard ratio [HR], 0.57). Smoking cessation was also associated with lower risk of other measured end points: death or recurrent MI (HR, 0.68) and death or heart failure hospitalization (HR, 0.65).

"The approximately 40 percent lower risk of all-cause mortality associated with smoking cessation compares favorably to other established therapies for patients with LV dysfunction after MI, including angiotensin-converting enzyme inhibitors (19 percent relative risk decrease), β-blockers (23 percent relative risk decrease), and aldosterone antagonists (15 percent relative risk decrease)," the authors write.

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