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Smoking Status and Risk for Recurrent Coronary Events after Myocardial Infarction

Thomas D. Rea, MD, MPH; Susan R. Heckbert, MD, PhD; Robert C. Kaplan, PhD; Nicholas L. Smith, MPH, PhD; Rozenn N. Lemaitre, PhD, MPH; and Bruce M. Psaty, MD, PhD
[+] Article and Author Information

Grant Support: By grants HL53375, HL40628, and HL43201 from the National Heart, Lung, and Blood Institute, Bethesda, Maryland.

Potential Financial Conflicts of Interest: None disclosed.

Requests for Single Reprints: Thomas D. Rea, MD, MPH, University of Washington, Cardiovascular Health Research Unit, Metropolitan Park, East Tower, 1730 Minor Avenue, Suite 1360, Seattle, WA 98101; e-mail, rea123@u.washington.edu.

Current Author Addresses: Drs. Rea, Heckbert, Smith, Lemaitre, and Psaty: University of Washington, Cardiovascular Health Research Unit, Metropolitan Park, East Tower, 1730 Minor Avenue, Suite 1360, Seattle, WA 98101.

Dr. Kaplan: Department of Epidemiology and Social Medicine, Belfer Room 1308C, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY 10461.

Author Contributions: Conception and design: T.D. Rea, S.R. Heckbert, B.M. Psaty.

Analysis and interpretation of the data: T.D. Rea, S.R. Heckbert, R.C. Kaplan, N.L. Smith, R.N. Lemaitre.

Drafting of the article: T.D. Rea, R.C. Kaplan.

Critical revision of the article for important intellectual content: T.D. Rea, S.R. Heckbert, R.C. Kaplan, N.L. Smith, R.N. Lemaitre.

Final approval of the article: T.D. Rea, S.R. Heckbert, R.C. Kaplan, N.L. Smith, B.M. Psaty.

Provision of study materials or patients: S.R. Heckbert, B.M. Psaty.

Statistical expertise: T.D. Rea, S.R. Heckbert, R.C. Kaplan, B.M. Psaty.

Obtaining of funding: S.R. Heckbert, B.M. Psaty.

Administrative, technical, or logistic support: S.R. Heckbert, R.C. Kaplan, B.M. Psaty.

Collection and assembly of data: S.R. Heckbert, R.C. Kaplan, B.M. Psaty.


Ann Intern Med. 2002;137(6):494-500. doi:10.7326/0003-4819-137-6-200209170-00009
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In the 2619 persons who survived to hospital discharge after a first myocardial infarction, the average age was 63.9 years; 37.7% of these persons were women. At the time of incident myocardial infarction, 880 patients (33.6%) were nonsmokers, 931 (35.5%) were former smokers, and 808 (30.9%) were active smokers. Of the 808 active smokers, 344 (42.6%) quit smoking during hospitalization for the incident myocardial infarction and 464 (57.4%) were active smokers at the time of hospital discharge. Of the 464 persons who were active smokers at hospital discharge, 105 quit smoking after discharge and before a recurrent event or censoring. Compared to persons who were smokers at the time of the incident myocardial infarction, nonsmokers and former smokers tended to be older, to have a greater body mass index, and to have a higher prevalence of diabetes and hypertension (Table 1). Characteristics were similar across quitter subgroups defined by duration of cessation. In the three groups with a history of smoking, the average number of cigarettes smoked per day was similar, whereas smoking duration was shorter for former smokers than for persons who quit during hospitalization or who continued to smoke.

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Summary for Patients

Continued Cigarette Smoking and the Risk for a Second Heart Attack

The summary below is from the full report titled “Smoking Status and Risk for Recurrent Coronary Events after Myocardial Infarction.” It is in the 17 September 2002 issue of Annals of Internal Medicine (volume 137, pages 494-500). The authors are TD Rea, SR Heckbert, RC Kaplan, NL Smith, RN Lemaitre, and BM Psaty.

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