Smoking cessation may add 3 years to post-CABG survival

5 September 2008

MedWire News: Coronary patients who smoke can potentially add 3 years to their life expectancy after coronary artery bypass grafting (CABP) by quitting the habit, research suggests.

"Smoking cessation turned out to have a greater effect on reducing the risk of mortality after CABG than any other intervention or treatment," say Ron van Domburg (Erasmus Medical Center, Rotterdam, The Netherlands) and colleagues.

The team identified 551 (53%) smokers among 1041 patients who underwent CABG between 1971 and 1980, at an average age of 51 years. Of the smokers, 43% quit after CABG and sustained this through the first year.

The 10-, 20-, and 30-year survival rates were 88%, 49%, and 19%, respectively, among smokers who quit; but the corresponding rates among persistent smokers were just 77%, 36%, and 11% (p<0.0001 for overall survival difference).

Cumulative survival was similar among persistent smokers and nonsmokers.

When comparing quitters with persistent smokers, quitting smoking was the most important survival factor, reducing patients' mortality risk by 40%. Other independent predictors of mortality were older age, impaired left ventricular fraction, and triple-vessel disease.

The protective effect of quitting smoking equated to an additional 3.5 years' life expectancy in patients younger than 50 years, 2.8 years in those aged 50-60 years, and 1.7 years in those older than 60 years.

The overall life expectancy was 20 years among patients who quit smoking versus 17 years in those who persisted, the researchers note in the American Heart Journal.

"Smoking cessation programs should start immediately, during hospitalization, after acute myocardial infarction, CABG, percutaneous coronary intervention, and vascular surgery to have the greatest probability of success," observes the team.

Am Heart J 2008; 156: 473-746