section name header

Evidence summaries

Smoking Cessation for the Secondary Prevention of Coronary Heart Disease

Smoking cessation may be effective in reducing mortality from ischaemic heart disease as well as non-fatal myocardial infarctions by more than 30%. Level of evidence: "C"

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A Cochrane review (abstract , review [Abstract]) [withdrawn from publication] included 20 observational studies.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).

The following decision support rules contain links to this evidence summary:

References

  • Critchley JA, Capewell S. WITHDRAWN: Smoking cessation for the secondary prevention of coronary heart disease. Cochrane Database Syst Rev 2012;(2):CD003041. [PubMed]
  • Biery DW, Berman AN, Singh A et al. Association of Smoking Cessation and Survival Among Young Adults With Myocardial Infarction in the Partners YOUNG-MI Registry. JAMA Netw Open 2020;3(7):e209649.[PubMed]

Primary/Secondary Keywords