NEW ORLEANS — Patients who quit smoking within a year after coronary artery bypass graft surgery prolong their life expectancy by an average of 3 years, Dr. Don Poldermans said at the annual meeting of the American College of Cardiology.
“This [information] is a practical tool for physicians … It may be the ultimate reason for the patient to quit smoking,” said Dr. Poldermans of Erasmus University, Rotterdam, the Netherlands.
It is well accepted that smoking cessation after coronary revascularization or MI reduces mortality risk. Dr. Poldermans presented the first study to quantify this benefit in years of life saved. He reported on 30-year outcomes for 1,041 consecutive patients who underwent venous CABG at the medical center during 1971–1980. At the time, 551 of the patients were smokers, of which 43% quit within the following year.
The 10-year survival was 88% in the smoking cessation group, compared with 77% in the persistent smokers. Survival at 15 and 30 years was 70% and 19%, respectively, in those who quit smoking, compared with 53% and 11% in those who did not.
The average life expectancy was 20 years for patients who quit smoking and 17 years for persistent smokers.
Smokers who were younger than 50 years at the time of CABG and who quit smoking within the next year lived an average of 3.5 years longer than those who continued smoking. Patients aged 50–60 years at surgery and who ceased smoking gained an average of 2.8 years, compared with persistent smokers. Those who quit after CABG after age 60 had a 1.7-year greater life expectancy than those who didn't quit.
Dr. Poldermans said these estimates are conservative because they derive from the early 1970s when CABG was reserved mostly for younger, otherwise healthy patients. The average age of the study population was 53 years; diabetes and other comorbid conditions were uncommon. Today's CABG patients are sicker, older, and higher risk than those of 30 years ago—and the greater a patient's risk, the greater the benefit of an effective intervention.