Quitting smoking drops heart attack risk to levels of never smokers
2013-09-01
(Press-News.org) Dr Min said: "Smoking is an established risk factor for cardiovascular disease. Studies have identified that quitting smoking can reduce heart attacks and death but have not examined the relationship of this salutary effect on the presence and severity of coronary artery disease (CAD). Our study aimed to find out what impact stopping smoking had on the risk of cardiovascular events, death and the severity of CAD."
The prospective CONFIRM (Coronary CT Evaluation for Clinical Outcomes: An International Multicenter Study) registry of 13,372 patients from 9 countries in Europe, North America and East Asia examined the risk of major adverse cardiac events in 2,853 active smokers, 3,175 past smokers and 7,344 never smokers.
Both active smokers and past smokers had a higher prevalence of severely blocked coronary arteries compared to non-smokers. This was determined using coronary computed tomographic angiography (CCTA), a non-invasive imaging technique that enables direct visualisation of the coronary arteries. Active and past smokers had a 1.5-fold higher probability of severe stenoses in 1 and 2 major heart arteries, and a 2-fold increased probability of severe stenoses in all 3 major heart arteries.
Dr Min, who is director of the Institute of Cardiovascular Imaging at the New York-Presbyterian Hospital and the Weill Cornell Medical College, said: "Our results show that quitting smoking does not reduce the amount of disease smoking causes in the coronary arteries, but it does reduce the risk of heart attack and death to the levels of non-smokers."
After 2.0 years of follow-up, 2.1% of the study patients experienced heart attacks or death. Rates of heart attack or death were almost 2-fold higher in active smokers compared to never smokers. Past smokers had the same rates or heart attack or death as never smokers, despite having a higher prevalence, extent and severity of CAD (see figure). The findings in both active and past smokers persisted even when they were matched with non smokers who were similar in age, gender and CAD risk factors.
Dr Min said: "Our study was the first to demonstrate that the presence and severity of coronary blockages do not go away with quitting smoking, but that the risk of heart attack and death does. Future studies are being pursued to determine how this protective effect may occur."
He continued: "Numerous questions remain and require further study. For example, will the severe blockages observed in patients who have quit smoking provoke adverse events after 2 years (the duration of the present study). Further, does the duration of smoking or the number of cigarettes smoked per day affect the severity of CAD or the prognosis related to quitting smoking. Our team and several others are pursuing such investigations."
Dr Min concluded: "It's never too late to quit smoking. This study clearly shows that stopping smoking lowers the risk of heart attacks and death to the level of never smokers."
###
Notes to editor
About the European Society of Cardiology
The European Society of Cardiology (ESC) represents more than 80 000 cardiology professionals across Europe and the Mediterranean. Its mission is to reduce the burden of cardiovascular disease in Europe.
About ESC Congress 2013
The ESC Congress is currently the world's premier conference on the science, management and prevention of cardiovascular disease. The spotlight of this year's event is "The Heart Interacting with Systemic Organs". ESC Congress 2013 takes place from 31 August to 4 September at the RAI centre in Amsterdam, Netherlands. More information is available from the ESC Press Office at press@escardio.org
END
ELSE PRESS RELEASES FROM THIS DATE:
2013-09-01
Aortic stenosis is the most common heart valve disease in the elderly. It is associated with congenital bicuspid aortic valve and previous rheumatic heart disease, but is also often caused by calcification of a normal valve. Calcification of a normal valve may be associated with atherosclerotic changes in the portion of the aorta closest to the valve.
Dr Ranthe said: "Genetic factors may play a role in the development of aortic stenosis. A single nucleotide polymorphism in the lipoprotein(a) locus has been associated with aortic valve calcification and aortic stenosis.1 ...
2013-09-01
AMSTERDAM, The Netherlands – In patients with non-ST-elevation acute coronary syndrome (NSTE- ACS), pre-treatment with the P2Y12 antagonist prasugrel prior to catheterization, significantly increases the risk of life-threatening bleeding without reducing the risk of major ischemic events, according to the results of the ACCOAST (A Comparison of Prasugrel at PCI or Time of Diagnosis of Non-ST Elevation Myocardial Infarction) trial.
The findings point to a "paradigm shift" away from pre-treatment in such patients which will not only be "hard to believe and destabilizing ...
2013-09-01
AMSTERDAM, The Netherlands – Heart attack patients with ST elevation who undergo a preventive procedure to unblock additional coronary arteries have significantly better outcomes than those whose treatment is confined to the culprit blockage only, according to the results of the Preventive Angioplasty in Myocardial Infarction (PRAMI) Trial.
The findings, presented today at the ESC and published simultaneously in the New England Journal of Medicine, provide information that will help guide clinical practice and resolve uncertainty over how to approach percutaneous coronary ...
2013-09-01
AMSTERDAM, The Netherlands – A shortened pre-surgical interruption of anti-thrombotic therapy, compared to the more traditional one-week interruption, has no influence on perioperative complications in cardiac patients, according to the results of the PRAGUE 14 trial.
"Thus, there is no evidence to support changing the traditional approach of interrupting antithrombotic therapy one week before surgery," said lead investigator Petr Widimsky, MD., DrSc., from the Cardiocenter of Charles University, in Prague, Czech Republic.
The results shed light on a persistent dilemma ...
2013-09-01
"The study was designed to show a better 4-hour survival in the group treated with mechanical chest compressions, and this was not achieved," said lead investigator Sten Rubertsson, MD, PhD, professor and specialist consultant at Uppsala University and Uppsala University Hospital.
"But we now have the scientific support to allow us to use mechanical chest compressions and defibrillate during ongoing compressions," he said, adding that this could potentially increase the efficiency and safety of emergency personnel as they deliver care during transportation of patients. ...
2013-09-01
AMSTERDAM, The Netherlands – In patients with atrial fibrillation, delayed enhancement magnetic resonance imaging (DE-MRI) performed before ablative treatment can stage the degree of damaged heart tissue (atrial fibrosis) and help predict whether treatment will be successful or not, according to results of Delayed Enhancement - MRI determinant of successful Catheter Ablation of Atrial Fibrillation (DECAAF) trial.
"The DECAAF results show that stage of atrial fibrosis prior to ablation is a new, powerful, independent predictor of outcome," said lead investigator Nasir ...
2013-09-01
AMSTERDAM, The Netherlands – In the treatment of venous thromboembolism (VTE), the oral anticoagulant edoxaban resulted in equal efficacy and better safety compared to standard warfarin when either drug was used with initial low molecular weight heparin (LMWH), according to the results of the Hokusai-VTE trial.
In the landscape of new trials with oral anticoagulants, the Hokusai-VTE findings offer fresh insight into a previously under-represented subgroup of patients with pulmonary embolism (PE), suggesting that treatment for this group might need to be different than ...
2013-09-01
AMSTERDAM, The Netherlands -- Aspiration of the blood clot or "thrombus" that causes a heart attack before re-opening a patient's artery with a balloon catheter does not improve survival compared to performing balloon dilation and stenting alone according to the results of the Thrombus Aspiration in ST- Elevation myocardial infarction in Scandinavia (TASTE) trial.
"We believe that TASTE questions the usefulness of thrombus aspiration as a routine adjunct and the recommendation for its general use in international guidelines should probably be down-graded," said lead author ...
2013-08-31
Dr Lin said: "Statins are widely used in the older population to reduce the risk of cardiovascular disease. But recent reports of statin-associated cognitive impairment have led the US Food and Drug Administration (FDA) to list statin-induced cognitive changes, especially for the older population, in its safety communications."
He added: "Previous studies had considered statin therapy to exert a beneficial effect on dementia. But few large-scale studies have focused on the impact of statins on new-onset, non-vascular dementia in the geriatric population."
Accordingly, ...
2013-08-31
Dr Gitt said: "There are wide variations between European countries in the achievement of LDL-cholesterol (LDL-C) targets. However the effect of different reimbursement systems on meeting the targets was unknown."
Between June 2008 and February 2009 DYSIS assessed the prevalence and types of persistent lipid abnormalities in patients receiving statins. Eligible patients were at high risk of a cardiovascular event, aged >45 years, and had been on chronic statin treatment for at least three months. A total of 22,063 patients were enrolled from 2,954 sites across 11 European ...
LAST 30 PRESS RELEASES:
[Press-News.org] Quitting smoking drops heart attack risk to levels of never smokers
