Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2012;65:719-25 - Vol. 65 Num.08 DOI: 10.1016/j.rec.2012.03.011

Attitude and Efficacy of Cardiologists With Respect to Smoking in Patients After Acute Coronary Syndromes

Alberto Cordero a,, Vicente Bertomeu-Martínez a, Pilar Mazón b, Juan Cosín c, Enrique Galve d, Iñaki Lekuona e, Fernando de la Guía f, José Ramón Gonzalez-Juanatey b

a Departamento de Cardiología, Hospital Universitario de San Juan, San Juan de Alicante, Alicante, Spain
b Departamento de Cardiología, Hospital Complejo Universitario de Santiago, Santiago de Compostela, A Coruña, Spain
c Departamento de Cardiología, Hospital Arnau de Vilanova, Valencia, Spain
d Departamento de Cardiología, Hospital Universitari Vall d’Hebron, Barcelona, Spain
e Departamento de Cardiología, Hospital de Galdakao, Galdakao, Vizcaya, Spain
f Departamento de Cardiología, Hospital Marina Baixa, Villajoyosa, Alicante, Spain

Keywords

Acute coronary syndromes. Smoking. Smoking cessation support. Abstinence.

Abstract

Introduction and objectives

Smoking is one of the most prevalent risk factors in acute coronary syndrome patients. The aim of this study was to assess the attitudes of cardiologists to the smoking habits of these patients

Methods

A prospective multicenter registry of acute coronary syndrome patients. The primary endpoint was defined as smoking abstinence and the secondary endpoint as the incidence of all-cause mortality or nonfatal myocardial infarction.

Results

The study population included 715 patients; 365 were current smokers. During follow-up (median, 375.0 days [interquartile range, 359.3-406.0 days]), 110 patients (30.6%) received smoking cessation support (19.7% at hospital discharge and 37.6% at month 3), specialized units and varenicline being the strategies most frequently used. No clinical differences were observed between patients who received smoking cessation support and those who did not, except for a higher prevalence of previous coronary heart disease in those who received support. In the multivariate analysis, the only variable independently associated with receiving smoking cessation support was previous coronary heart disease (odds ratio=3.16; 95% confidence interval, 1.64-6.11; P<.01). The abstinence rate was 72.3% at month 3 and 67.9% at 1 year; no differences were observed between the patients who received smoking cessation support and those who did not. During follow-up, a nonsignificant trend toward a lower incidence of the secondary endpoint was observed among the patients who were smokers at the time of acute coronary syndrome and who achieved abstinence (P=.07).

Conclusions

Use of smoking cessation support strategies is limited in acute coronary syndrome patients and is more widespread among those with previous coronary heart disease.

1885-5857/© 2012 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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