The long-term risk of smoking in diabetic patients with stable ischemic heart disease treated with intensive medical therapy and lifestyle modification

European Journal of Preventive Cardiology
Asrar A KhanDavid L Brown

Abstract

Introduction The long-term risk of smoking in diabetic patients with stable ischemic heart disease (SIHD) is unknown. We sought to analyze the impact of smoking on outcomes of diabetic patients with SIHD when other cardiovascular risk factors are being aggressively treated. Methods The Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) trial randomized 2368 diabetics with SIHD to intensive medical therapy (IMT) with prompt revascularization or IMT alone. Smoking status was obtained at baseline, 6 months, and 1, 2, 3, 4 and 5 years. The primary endpoint of interest was all-cause mortality. Results Of 2360 patients, 33.1% of patients never smoked, 54.4% were former smokers, and 12.5% were current smokers. The rate of all-cause mortality was greater for current (2.5 deaths/100 patient-years) and former smokers (3.1 deaths/100 patient-years) than never smokers (2.1 deaths/100 patient-years) (P = 0.007). Cardiac death, cardiovascular death, fatal or nonfatal myocardial infarction, and fatal or nonfatal stroke were not increased in current or former smokers compared with never smokers. Compared with never smokers, current smokers experienced a 49% increased hazard of death (Hazard Ratio (HR) 1.49, 95% Confidence ...Continue Reading

References

May 18, 2004·Journal of the American College of Cardiology·John A Ambrose, Rajat S Barua
Jul 4, 2006·The American Journal of Cardiology·Maria Mori BrooksUNKNOWN Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) Trial Investigators
Jul 29, 2006·European Journal of Cardiovascular Prevention and Rehabilitation : Official Journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology·Serena Tonstad, J Andrew Johnston
Jun 9, 2009·The New England Journal of Medicine·UNKNOWN BARI 2D Study GroupBurton E Sobel
Oct 31, 2009·Primary Care Diabetes·Robert H Fagard, Peter M Nilsson
Jul 7, 2010·Expert Review of Cardiovascular Therapy·Reena S Shah, John W Cole
May 17, 2012·Clinical Cardiology·Tao ChenJin Guo
Jan 25, 2013·The New England Journal of Medicine·Prabhat JhaRichard Peto
Jul 31, 2013·The American Journal of Cardiology·Sanneke P M de BoerUNKNOWN interventional cardiologists of the Thoraxcentre 1980 to 1985
Jan 9, 2014·JAMA : the Journal of the American Medical Association·Marie NgEmmanuela Gakidou
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Oct 29, 2015·The New England Journal of Medicine·Mauro TancrediMarcus Lind

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Citations

Sep 13, 2017·European Journal of Preventive Cardiology·Massimo F Piepoli
Feb 26, 2019·European Journal of Preventive Cardiology·Massimo F Piepoli

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Methods Mentioned

BETA
coronary artery bypass

Software Mentioned

BARI
SAS

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