A retrospective cohort study 2 included 2072 patients who experienced an initial MI at 50 years or younger. Smoking status at the time of presentation and at 1 year after MI was determined from electronic medical records. 1088 were smokers at the time of their index hospitalization. Over a median follow-up of 11.2 years (interquartile range, 7.3-14.2 years), individuals who quit smoking had a statistically significantly lower rate of all-cause mortality (hazard ratio [HR], 0.35, 95% CI 0.19 to 0.63; P < .001) and cardiovascular mortality (HR 0.29, 95% CI 0.11 to 0.79; P = .02). These values remained statistically significant after propensity score adjustment (HR 0.30 [95% CI 0.16 to 0.56; P < .001] for all-cause mortality and 0.19 [95% CI 0.06 to 0.56; P = .003] for cardiovascular mortality).
A Cochrane review (abstract , review [Abstract]) [withdrawn from publication] included 20 observational studies. There was a 36% reduction in crude relative risk (RR) of mortality for those who quit smoking compared with those who continued to smoke (RR 0.64, 95% confidence interval 0.58 to 0.71). There was also a reduction in non-fatal myocardial infarctions (crude RR 0.68, 95% confidence interval 0.57 to 0.82).
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