Patients who smoked before and after an acute MI had increased risk for angina and poorer health-related quality of life than those who had never smoked or quit smoking prior to or within 1 year after MI in a recent study.
The analysis included data on 4,003 patients collected from two multicenter, prospective acute MI registries in the United States: PREMIER and TRIUMPH. Smoking status and health-related quality of life were assessed at admission and 1, 6 and 12 months following acute MI. The researchers assessed angina and quality of life according to patient responses to the Seattle Angina Questionnaire and the SF-12 Physical and Mental Component Scales.
Upon hospitalization for acute MI, 29% of patients were never smokers, 34% had quit prior to MI and 37% were considered current smokers. Of the current smokers, 46% quit within 1 year after their MI, and the remaining patients were identified as persistent smokers.
Angina, quality of life and SF-12 Mental Component Scale scores improved for all groups over the course of follow-up, while SF-12 Physical Component Scale scores did not significantly change. After adjustment for confounders, patients who were former or never smokers exhibited similar quality of life and better health-related quality of life than active smokers and recent quitters. Patients who had recently quit had similar angina risk and SF-12 Mental Component scores to patients who had never smoked, but had significantly lower quality of life (mean 2.68-point difference; P = .003) and SF-12 Physical Component Scale scores (mean 2.28-point difference; P < .001).
Patients who had continued smoking over the course of follow-up were at increased risk for angina at 1 year (OR = 1.46; 95% CI, 1.14-1.87) and had poorer quality of life (mean 3.46-point difference; P < .001), SF-12 Physical Component Scale scores (mean 1.6-point difference; P = .003) and SF-12 Mental Component Scale scores (mean 2.34-point difference; P < .001) compared with never-smokers.
Compared with persistent smokers, those who had recently quit had significantly better SF-12 Mental Component Scale scores (P < .0001), but similar Physical Component Scale scores, quality of life and angina risk.
“Our findings provide unique information to post-[acute MI] patients and should provide strong support for counseling patients about how smoking cessation not only reduces the risk of MI and death, but is also associated with better health status over time,” the researchers concluded. “As such, these observations may offer current smokers increased incentive and motivation for quitting.” – by Adam Taliercio
Disclosure: One of the researchers owns the copyright for the Seattle Angina Questionnaire.