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Smoking Cessation After Surgery and Midterm Outcomes of Surgical Revascularization Publisher Pubmed



Masoudkabir F1, 2 ; Yavari N3 ; Pashang M3 ; Sadeghian S2, 3 ; Jalali A3 ; Karimi A4 ; Bagheri J4 ; Abbasi K4 ; Davoodi S4 ; Omran AS4 ; Shirzad M4 ; Ahmadi Tafti SH4
Authors
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Authors Affiliations
  1. 1. Cardiac Primary Prevention Research Center, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Research Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
  4. 4. Department of Cardiac Surgery, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran

Source: Annals of Thoracic Surgery Published:2020


Abstract

Background: Although multiple studies have reported the devastating effect of cigarette smoking (CS) on short-term outcomes of patients who underwent coronary artery bypass grafting surgery (CABG), its effect on long-term outcomes is still questionable. We aimed to evaluate the long-term outcomes of CS cessation after CABG surgery. Methods: This retrospective cohort study included all patients who underwent isolated CABG at our center between 2007 and 2016 and were cigarette smokers either just before or at the time of surgery. Patients were stratified into those who continued CS and those who were persistently CS abstinent after CABG. The endpoints of the study were 5-year mortality and 5-year major adverse cardiovascular and cerebrovascular events. Results: Of 28,945 patients who underwent isolated CABG, 9173 current cigarette smokers (93.5% men; mean age, 58.6 years) met our selection criteria and were included in the final analysis. Of these 3302 patients (40.0%) continued CS after surgery and 5688 patients were persistently abstinent. Multivariable survival analysis demonstrated that CS cessation after CABG, adjusted for major coronary risk factors, could reduce the 5-year mortality by 35% (hazard ratio, 0.65; 95% confidence interval, 0.54-0.77; P < .001) and 5-year major adverse cardiovascular and cerebrovascular events by 18% (hazard ratio, 0.82; 95% confidence interval, 0.74-0.92; P = .001). Conclusions: Our study shows that CS abstinence after CABG significantly reduces long-term mortality and number of major adverse events. As a result, patients who smoke should be encouraged to participate in CS cessation programs after CABG surgery. © 2020 The Society of Thoracic Surgeons