(Circulation. 1996;93:42-47.)
© 1996 American Heart Association, Inc.
Articles |
Smoking and Cardiac Events After Venous Coronary Bypass Surgery
A 15-Year Follow-up Study
From Cardiology R&D Department (A.A.V.), Department of Cardiology (H.W.T.P., S.M.P.G.E., N.M.E.), and Department of Cardiothoracic Surgery (F.E.E.V.), St Antonius Hospital, Nieuwegein; Department of Cardiology (B.L. van B.), Diaconessenhuis, Eindhoven; and Department of Clinical Epidemiology (E.M.K., J.G.P.T.), Academic Medical Center, Amsterdam, the Netherlands.
Correspondence to H.W.T. Plokker, Department of Cardiology, St Antonius Hospital, Koekoekslaan 1, 3435 CM Nieuwegein, the Netherlands.
Background The long-term clinical effects of smoking and smoking cessation after venous coronary bypass surgery have not been well established.
Methods and Results Four hundred fifteen patients who underwent venous coronary bypass surgery between April 1976 and April 1977 were followed up prospectively for 15 years. Multivariate Cox survival analysis revealed that patients who smoked at the time of surgery had no elevated risks for clinical events compared with nonsmokers. However, smoking behavior at 1 and 5 years after surgery appeared to be an important predictor of clinical events during the subsequent follow-up period. Compared with patients who stopped smoking since surgery, smokers at 1 year after surgery had more than twice the risk for myocardial infarction and reoperation. Patients who were still smoking at 5 years after surgery had even more elevated risks for myocardial infarction and reoperation and a significantly increased risk for angina pectoris compared with patients who stopped smoking since surgery and patients who never smoked. Patients who started to smoke again within 5 years after surgery had increased risks for reoperation and angina pectoris. No differences in outcome were found between patients who stopped smoking since surgery and nonsmokers.
Conclusions Our results show that smoking cessation after coronary bypass surgery may have important beneficial effects on clinical events during long-term follow-up.
Key Words: smoking • bypass • follow-up studies
This article has been cited by other articles:
 |
|
 |
|
  T. M. Maddox, K. J. Reid, J. A. Spertus, M. Mittleman, H. M. Krumholz, S. Parashar, P. M. Ho, and J. S. Rumsfeld Angina at 1 Year After Myocardial Infarction: Prevalence and Associated Findings Arch Intern Med, June 23, 2008; 168(12): 1310 - 1316. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. M.A. van de Wal, B. L. van Brussel, A. A. Voors, T. D.J. Smilde, J. C. Kelder, H. A. van Swieten, W. H. van Gilst, D. J. van Veldhuisen, and H.W. T. Plokker Mild preoperative renal dysfunction as a predictor of long-term clinical outcome after coronary bypass surgery J. Thorac. Cardiovasc. Surg., February 1, 2005; 129(2): 330 - 335. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. F. Sabik III, B. W. Lytle, E. H. Blackstone, M. Khan, P. L. Houghtaling, and D. M. Cosgrove Does competitive flow reduce internal thoracic artery graft patency? Ann. Thorac. Surg., November 1, 2003; 76(5): 1490 - 1497. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. F. Akowuah, P. J. Sheridan, G. J. Cooper, and C. Newman Preventing saphenous vein graft failure: does gene therapy have a role? Ann. Thorac. Surg., September 1, 2003; 76(3): 959 - 966. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Tsiara, M. Elisaf, and D. P. Mikhailidis Influence of Smoking on Predictors of Vascular Disease Angiology, September 1, 2003; 54(5): 507 - 530. [Abstract] [PDF]
|
|
|
|
 |
|
 J. A. Critchley and S. Capewell Mortality Risk Reduction Associated With Smoking Cessation in Patients With Coronary Heart Disease: A Systematic Review JAMA, July 2, 2003; 290(1): 86 - 97. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B.L van Brussel, A.A Voors, J.M.P.G Ernst, P.J Knaepen, and H.W.M Plokker Venous coronary artery bypass surgery: a more than 20-year follow-up study Eur. Heart J., May 2, 2003; 24(10): 927 - 936. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. E. Charlson and O. W. Isom Care after Coronary-Artery Bypass Surgery N. Engl. J. Med., April 10, 2003; 348(15): 1456 - 1463. [Full Text] [PDF]
|
|
|
|
 |
|
 C. Bolman, H. de Vries, and G. van Breukelen Evaluation of a nurse-managed minimal-contact smoking cessation intervention for cardiac inpatients Health Educ. Res., February 1, 2002; 17(1): 99 - 116. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. C. Smith Jr, J. T. Dove, A. K. Jacobs, J. Ward Kennedy, D. Kereiakes, M. J. Kern, R. E. Kuntz, J. J. Popma, H. V. Schaff, D. O. Williams, et al. ACC/AHA guidelines for percutaneous coronary intervention (revision of the 1993 PTCA guidelines): A report of the American College of Cardiology/ American Heart Association Task Force on practice guidelines (Committee to revise the 1993 guidelines for percutaneous transluminal coronary angioplasty) endorsed by the Society for Cardiac Angiography and Interventions J. Am. Coll. Cardiol., June 15, 2001; 37(8): 2239 - 2239. [Full Text] [PDF]
|
|
|
|
|
|
J.W. Deckers Smoking and survival in acute coronary syndrome: the fog is clearing Eur. Heart J., May 1, 2001; 22(9): 724 - 726. [PDF]
|
|
|
|
 |
|
 D. A. Taira, T. B. Seto, K. K. L. Ho, H. M. Krumholz, D. E. Cutlip, R. Berezin, R. E. Kuntz, and D. J. Cohen Impact of Smoking on Health-Related Quality of Life After Percutaneous Coronary Revascularization Circulation, September 19, 2000; 102(12): 1369 - 1374. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. T. van Domburg, K. Meeter, D. F. M. van Berkel, R. F. Veldkamp, L. A. van Herwerden, and A. J. J. C. Bogers Smoking cessation reduces mortality after coronary artery bypass surgery: a 20-year follow-up study J. Am. Coll. Cardiol., September 1, 2000; 36(3): 878 - 883. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. D. Clouse, H. Yamaguchi, M. R. Phillips, R. D. Hurt, L. A. Fitzpatrick, T. P. Moyer, C. Rowland, H. V. Schaff, and V. M. Miller Effects of transdermal nicotine treatment on structure and function of coronary artery bypass grafts J Appl Physiol, September 1, 2000; 89(3): 1213 - 1223. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W D. Clouse, K. S Rud, R. D Hurt, and V. M Miller Short-term treatment with transdermal nicotine affects the function of canine saphenous veins Vascular Medicine, May 1, 2000; 5(2): 75 - 82. [Abstract] [PDF]
|
|
|
|
|
|
K. Wilson, N. Gibson, A. Willan, and D. Cook Effect of Smoking Cessation on Mortality After Myocardial Infarction: Meta-analysis of Cohort Studies Arch Intern Med, April 10, 2000; 160(7): 939 - 944. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T.F.M. Van Berkel, H. Boersma, J.W. Roos-Hesselink, R.A.M. Erdman, and M.L. Simoons Impact of smoking cessation and smoking interventions in patients with coronary heart disease Eur. Heart J., December 2, 1999; 20(24): 1773 - 1782. [PDF]
|
|
|
|
|
|
E.-S. Tan, J. van der Meer, P. Jan de Kam, P. H. J. M. Dunselman, B. J. M. Mulder, C. A. P. L. Ascoop, M. Pfisterer, K. I. Lie, and for CABADAS Research Group of the Interuniversity Worse clinical outcome but similar graft patency in women versus men one year after coronary artery bypass graft surgery owing to an excess of exposed risk factors in women J. Am. Coll. Cardiol., November 15, 1999; 34(6): 1760 - 1768. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T.F.M. Van Berkel, H. Boersma, D. De Baquer, J.W. Deckers, and D. Wood Registration and management of smoking behaviour in patients with coronary heart disease. The EUROASPIRE survey Eur. Heart J., November 2, 1999; 20(22): 1630 - 1637. [Abstract] [PDF]
|
|
|
|
|
|
K. A. Eagle, R. A. Guyton, R. Davidoff, G. A. Ewy, J. Fonger, T. J. Gardner, J. P. Gott, H. C. Herrmann, R. A. Marlow, W. C. Nugent, et al. ACC/AHA guidelines for coronary artery bypass graft surgery: A report of the American College of Cardiology/ American Heart Association task force on Practice Guidelines (Committee to revise the 1991 Guidelines for Coronary Artery Bypass Graft Surgery) J. Am. Coll. Cardiol., October 1, 1999; 34(4): 1262 - 1347. [Full Text] [PDF]
|
|
|
|
 |
|
 R RICHMOND Opening the window of opportunity: encouraging patients to stop smoking Heart, May 1, 1999; 81(5): 456 - 458. [Full Text]
|
|
|
|
|
|
J. G. Motwani and E. J. Topol Aortocoronary Saphenous Vein Graft Disease : Pathogenesis, Predisposition, and Prevention Circulation, March 10, 1998; 97(9): 916 - 931. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. M. Murabito, R. B. D'Agostino, H. Silbershatz, and P. W. F. Wilson Intermittent Claudication : A Risk Profile From The Framingham Heart Study Circulation, July 1, 1997; 96(1): 44 - 49. [Abstract] [Full Text]
|
|
|
|
|
|
D. Hasdai, K. N. Garratt, D. E. Grill, A. Lerman, and D. R. Holmes Effect of Smoking Status on the Long-Term Outcome after Successful Percutaneous Coronary Revascularization N. Engl. J. Med., March 13, 1997; 336(11): 755 - 761. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. Payne and C. Saul Variations in use of cardiology services in a health authority: comparison of coronary artery revascularisation rates with prevalence of angina and coronary mortality BMJ, January 25, 1997; 314(7076): 257 - 257. [Abstract] [Full Text]
|
|
|
|
 |
|
 Smoking May Cause Repeat CABG Journal Watch Cardiology, February 1, 1996; 1996(201): 3 - 3. [Full Text]
|
|
|
|
 |
|
 SMOKING AFTER BYPASS SURGERY RAISES LONG-TERM COMPLICATION RATES Journal Watch (General), January 12, 1996; 1996(112): 2 - 2. [Full Text]
|
|