IMPACT OF SMOKING STATUS ON SHORT TERM CLINICAL OUTCOMES OF DRUG ELUTING STENTS IN PATIENTS WITH STABLE CORONARY ARTERY DISEASE

Abstract

Objective: To evaluate the impact of smoking status on short-term clinicaloutcomes of Drug Eluting Stents (DES) in patients with stable coronary arterydisease.

Methodology: This cross sectional study was carried out at the Department ofCardiology, Lady Reading Hospital Peshawar from April 2011 to July 2012. Itincluded all patients with stable coronary disease undergoing DES implantation.Smoking status was assessed on the basis of information obtained from hospitalmedical records at the time of first medical examination and rechecked bytelephone interview. All patients were classified as non-smokers and smokers.Clinical outcomes (Myocardial infarction [MI], unstable angina [UA], and positiveETT) at three months stratified by smoking status were measured in patients whoreceived DES for coronary artery lesions. All patients were followed andreassessed after 3 months from the index procedure. Exercise Tolerance Test(ETT) was performed on every patient and recorded on proforma. Data analysiswas done using SPSS version 16.

Result: A total of 376 patients were enrolled in this study. The mean age was57±9.313 years. Males were 271(72.1%). Among 376 patients who werefollowed up, 70 of them were smokers (18.6%) at the index procedure, 306patients (81.4%) were non-smokers. The frequency of dyslipidemia and diabetesmellitus was higher in smokers as compared to non-smokers. Mean stent lengthin smokers was 27.824±6.23mm as compared to 26.592±4.73mm in nonsmokers.Mean stent diameter was 2.91±0.347mm in smoker group while itwas 3.01±0.141mm in non-smoker group. Most of the patients in both groupsunderwent DES implantation to LAD and LCx arteries. There were significantlyhigher rates of myocardial infarction (7.1% vs 2%, p<0.036),unstable angina(22.9% vs 3.3%, p<0.001) and positive ETT (30% vs 5.2%, p<0.001) in thesmoker group as compared to non-smoker group.

Conclusion: This study provides evidence that smokers treated with DESexperience higher rates of myocardial infarction, unstable angina and positiveETT at three months as compared to non-smokers, particularly in the setting ofstable coronary artery disease.