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Nonsmokers and former smokers (including those who quit more than a month prior to surgery) suffer from fewer physical limitations, less angina (crushing chest pain), and have a higher quality of life than smokers following coronary angioplasty, concludes a study supported in part by the Agency for Healthcare Research and Quality (HS11282). The impact of not smoking on postoperative angina frequency was powerful, similar to that seen for the impact of coronary angioplasty itself on frequency of angina.
Researchers from the Mid America Heart Institute, St. Luke's Hospital, and the University of Missouri prospectively studied a group of 271 coronary angioplasty patients at a high-volume coronary treatment center. They assessed the patients' health with the Short Form-12 (SF-12) measure of physical and mental functioning and the 19-item Seattle Angina Questionnaire (SAQ) at baseline and at 6 and 12 months after surgery. Patients who were current smokers had poorer health status outcomes than other patients after angioplasty.
At 1 year after surgery, people who had never smoked and ex-smokers still scored significantly higher than current smokers in the physical component of the SF-12, indicating a better general physical quality of life (42.7 and 41.2 vs. 30.4). There was little impact of smoking on the SF-36 mental component scores at 6 or 12 months. Based on SAQ scores, 6 months after the procedures, smokers had significantly more physical limitations, more frequent angina, and poorer quality of life than nonsmokers and ex-smokers. Smoking status was unrelated to mortality rate during the year after coronary angioplasty. The researchers conclude that cardiologists should aggressively promote a tobacco-free lifestyle in their patients and advise patients to quit smoking before cardiac revascularization surgery.
See "Smoking and health outcomes after percutaneous coronary intervention," by C. Keith Haddock, Ph.D., Walker S. Poston, Ph.D., Jennifer E. Taylor, M.A., and others, in the American Heart Journal 145, pp. 652-657, 2003.
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