Association of Smoking Cessation and Survival Among Young Adults With Myocardial Infarction in the Partners YOUNG-MI Registry
| Autor: | Arman Qamar, Avinainder Singh, Jon Hainer, Marcelo F. Di Carli, Ron Blankstein, David W Biery, Michael J. Blaha, Adam N Berman, Deepak L. Bhatt, Josh Klein, Ersilia M. DeFilippis, Khurram Nasir, Amber Fatima, Sanjay Divakaran, Bradley Collins, Ankur Gupta |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Cardiology Myocardial Infarction National Death Index Internal medicine Medicine Humans Registries Propensity Score Cause of death Original Investigation business.industry Research Hazard ratio Smoking Retrospective cohort study General Medicine Middle Aged Featured Online Only Master file Case-Control Studies Cohort Smoking cessation Female Smoking Cessation business Cohort study |
| Zdroj: | JAMA Network Open |
| ISSN: | 2574-3805 |
| Popis: | This cohort study identifies the prevalence of tobacco use and examines the association of both smoking and smoking cessation with survival in a cohort of adults who experienced a myocardial infarction at a young age. Key Points Question Is smoking cessation associated with lower mortality among young adults after an initial myocardial infarction (MI)? Findings In this cohort study of 2072 individuals who experienced an initial MI at 50 years or younger, approximately half were smokers at the time of their MI, and 62% continued to smoke at 1 year after MI. Smoking cessation within 1 year after MI was associated with a statistically significant reduction in long-term all-cause and cardiovascular mortality. Meaning Smoking cessation after MI was associated with a clinically significant reduction in all-cause and cardiovascular mortality in a cohort of patients who experienced an MI at a young age. Importance Despite significant progress in primary prevention, the rate of myocardial infarction (MI) continues to increase in young adults. Objectives To identify the prevalence of tobacco use and to examine the association of both smoking and smoking cessation with survival in a cohort of adults who experienced an initial MI at a young age. Design, Setting, and Participants The Partners YOUNG-MI registry is a retrospective cohort study from 2 large academic centers in Boston, Massachusetts, that includes patients who experienced an initial MI at 50 years or younger. Smoking status at the time of presentation and at 1 year after MI was determined from electronic medical records. Participants were 2072 individuals who experienced an MI at 50 years or younger between January 2000 and April 2016. The dates of analysis were October to December 2019. Main Outcomes and Measures Deaths were ascertained from the Social Security Administration Death Master File, the Massachusetts Department of Vital Statistics, and the National Death Index. Cause of death was adjudicated independently by 2 cardiologists. Propensity score–adjusted Cox proportional hazards modeling was used to evaluate the association between smoking cessation and both all-cause and cardiovascular mortality. Results Among the 2072 individuals (median age, 45 years [interquartile range, 42-48 years]; 1669 [80.6%] men), 1088 (52.5%) were smokers at the time of their index hospitalization. Of these, 910 patients were further classified into either the cessation group (343 [37.7%]) or the persistent smoking group (567 [62.3%]) at 1 year after MI. Over a median follow-up of 11.2 years (interquartile range, 7.3-14.2 years), individuals who quit smoking had a statistically significantly lower rate of all-cause mortality (hazard ratio [HR], 0.35; 95% CI, 0.19-0.63; P |
| Databáze: | OpenAIRE |
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