Beneficial effect of stopping smoking on future cardiac events in male smokers with previous myocardial infarction.

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Abstract
We assessed the effect of stopping smoking on future cardiac events (cardiac death and non-fatal myocardial infarction (MI)) in 90 male smokers with previous MI by a prospective follow-up study. At the time of enrollment, the patients were divided into 2 groups according to their current smoking status (Group A: those who had stopped smoking (n = 60), and Group B: those who were still smoking (n = 30)). Follow-up was performed prospectively by annual postal questionnaires. During the mean follow-up period of 3.1 +/- 1.4 years, 13 cardiac events (11 cardiac deaths and 2 cases of non-fatal MI) occurred in the 87 evaluable patients. The cardiac event rates in Groups A and B were 8.5% and 28.6%, respectively, and the relative risk was 3.4 (Group A vs B, p less than 0.05) by univariate analysis. The relative risk using multivariate analysis (Cox) was also statistically significant (3.1, p less than 0.05). HDL-cholesterol was significantly lower in Group B than in Group A, but other coronary risk factors apart from smoking were not significantly different between the two groups. At the end of the follow-up period, 89.8% of the patients in Group A remained nonsmokers and 21% of the patients in Group B had stopped smoking. Stopping smoking significantly reduced the risk of future cardiac events in male smokers with previous MI. This prospective follow-up study demonstrated that a significant reduction in the risk of future cardiac events could be achieved by stopping smoking in this group of patients.

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