Young adult smoker quitting smoking in the first year of the first year Myocardial infarction (MI) The chances of dying over the next 10 years are much less than those of peers who continue to smoke. However, nearly two-thirds continue to smoke after the event, according to new data from Partners YOUNG-MI Registry.
“Smoking is one of the most common risk factors for developing MI in younger ages (causing about 50% of the time. This causes more young individuals to avoid or stop using tobacco.” The need to do this is increasing.” Ron Blankstein, Brigham and Women’s Hospital, MD and Harvard Medical School in Boston, theheart.org | Medscape Cardiology..
Still, the findings that 62% of youth a year after MI continue to smoke, point to the “great need for better smoking cessation efforts after a heart attack.”
“Strong” Message to Clinician
“This study adds to a very strong body of evidence that will quit smoking and lead to longevity,” said Michael Fiore, MD, MPH, MBA, University of Wisconsin Tobacco Research and Intervention Center, Madison. People who were not involved in a study..
“As a doctor, nothing can have a bigger impact on patients than to quit smoking. This study is a strong call for clinicians to intervene in smoking patients,” he said. theheart.org | Medscape Cardiology..
The study included 2072 individuals under the age of 50 (median, 45, 81% male) who were hospitalized for their first MI at two large academic medical centers in Boston. Of these, 33.9% were unsmokers, 13.6% were former smokers, and 52.5% were smokers at MI.
During the median follow-up of 10.2 years, those who quit smoking had significantly reduced mortality from all causes (unadjusted hazard ratio). [HR], 0.35; 95% CI, 0.19-0.63; P <.001) and cardiovascular (CV) causes (HR, 0.29; 95% CI, 0.11-0.79; P = .02), compared to those who continued to smoke.
Results remained statistically significant in a trend-matched analysis of both causes (HR, 0.30; 95% CI, 0.16-0.56; P <.001) and CV mortality (HR, 0.19; 95% CI, 0.06-0.56; P = .003).
“Patients who quit smoking were similar to those who continued to smoke with regard to baseline characteristics, but quitting smoking was associated with an all-cause and approximately 70-80% reduction in CV mortality,” the authors write. As stated in the paper, 8 July Online JAMA Network Open..
They also note that the long-term mortality rates of unsmokers and ex-smokers who quit before MI were similar.
“Failure of our healthcare system”
According to Brunstein, the conclusion is: “It’s never too late to quit smoking, and people who have experienced MI should do it the right way. Our medical system has a lot of room for improvement, so We need to facilitate such efforts.”
“When you look at articles like these, there’s no better way to improve quality of life and longevity than quitting smoking,” Fiore said.
The observation that many patients continue to smoke after MI is “a failure of our healthcare system and the failure of these individuals to overcome their strong nicotine dependence is an individual failure.
There is no “magic bullet” to overcome Nicotine addictionHowever, he said there are approved treatments that can “significantly increase smoking cessation rates.”
The two most effective smoking cessation treatments are Varenicline (Chantix) And nicotine replacement therapy, especially when combined with some simple counseling, the patch was ideally combined with nicotine mini lozenges, Fiore said.
He asks a cardiologist to promise the patient to quit smoking, 1-800-QUIT-NOW or SmokeFree.gov..
Funding for the research was provided by grants from the National Heart, Lung, and Blood Institutes. Blankstein reported receiving research support from Amgen and Astellas. Fiore has no relevant disclosures.
JAMA Netw Open. Published online 8th July 2020.
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