10:27am Tuesday 22 October 2019

Quitting smoking after heart attack reduces chest pain, improves quality of life


Study Highlights

  • Smoking after a heart attack is associated with more chest pain and worse health-related quality of life.
  • Smokers who quit after a heart attack have similar levels of chest pain and mental health as non-smokers. 

DALLAS — Smokers who quit after having a heart attack have similar levels of chest pain and mental health as non-smokers, according to research in the American Heart Association journal Circulation: Cardiovascular Quality and Outcomes.

Researchers assessed 4,003 adults in two U.S. multi-center heart attack patient registries for smoking, chest pain and health-related quality of life measures, such as physical and mental components at admission, at one, six and 12 months after their heart attacks. 

At admission, patients were identified as those who never smoked (29 percent), former smokers who quit before their heart attacks (34 percent) and active smokers (37 percent). Of the active smokers, 46 percent quit smoking within the first year after their heart attacks.

Researchers found worsening health status with continued smoking. 

  • Heart attack patients who never smoked had the best health status.
  • Those who stopped smoking before a heart attack were similar in health status to those who never smoked.
  • Smokers who quit within a year after a heart attack had intermediate levels of chest pain and mental health similar to those who never smoked. 
  • Those who continued to smoke after a heart attack had the worst health status of the four groups. At the one-year follow-up, persistent smokers had 1.5-fold higher odds of having chest pain compared to those who never smoked. Their assessment scores were 3.5 points lower for quality of life related to chest pain, 1.6 points lower for general physical functioning and 2.3 points lower for general mental health.

“Healthcare providers should counsel patients about how smoking cessation not only reduces the risk of death and having another heart attack, but also reduces the risk of having chest pain and may likely improve general mental health,” said Donna Buchanan, Ph.D., study lead author, psychologist and a researcher and manager with Saint Luke’s Mid America Heart Institute’s cardiovascular outcomes research group.

The study’s findings support previous research, reinforce the message that smoking has negative effects on health and strengthens the case to provide more education for heart attack patients.

“This information may offer current smokers increased motivation to quit smoking,” said Buchanan, who is also an associate professor at the University of Missouri-Kansas City’s School of Medicine.

“Current educational efforts tend to focus on how continued smoking increases the risk of recurrent heart attack and death, but health-related quality of life is often equally or more important to patients than longevity,” she said.

Smoking is one of the most preventable cause of premature death in the United States, according to the American Heart Association. It increases the risk of several disorders, including atherosclerosis (the buildup of fatty substances in the arteries), which can lead to heart disease and stroke.

Co-authors are Suzanne Arnold, M.D., M.H.A.; Kensey Gosch, M.S.; Philip Jones, M.S.; Lance Longmore, D.O.; John Spertus, M.D., M.P.H.; and Sharon Cresci, M.D. Author disclosures are on the manuscript.

The National Institutes of Health; National Heart, Lung, and Blood Institute; and CV Therapeutics Inc. funded the study.

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Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study =]authors and do not necessarily reflect the association’s policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at www.heart.org/corporatefunding.

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