NEW YORK (Reuters Health) – Patients who quit smoking after undergoing coronary artery bypass graft (CABG) surgery can expect to live 3 years longer than patients who continue to smoke, new research suggests.

In fact, “smoking cessation turns out to have a greater effect on reducing mortality than the effect of any other intervention or treatment after CABG,” the Dutch researchers report in the American Heart Journal for September.

Dr. Ron T. van Domburg and colleagues at Erasmus Medical Center in Rotterdam analyzed the 30-year clinical outcomes of 1041 patients who underwent a first isolated venous CABG procedure between 1971 and 1980.

The current analysis involves the 551 patients who were smokers, including 43% who stopped smoking throughout the first postoperative year and 57% who persisted in smoking. Vital statistics were obtained from civil registries.

During a median follow-up of 29 years, “the cumulative 10-, 20-, and 30-year survival rates were 88%, 49%, and 19%, respectively, in the group of patients who quit smoking,” the authors report, “and 77%, 36%, and 11%, respectively, in the persistent smokers (p < 0.0001)."

Life expectancy for quitters was 20.0 years, versus 17.0 years for patients who continued to smoke.

According to the authors, the 38% mortality reduction that they observed among quitters is greater than that achieved with other secondary prevention therapies, including aspirin, statins, and angiotensin-converting enzyme inhibitors.

Because smoking is the most important modifiable risk factor for an adverse prognosis, Dr. van Domburg’s team emphasizes that “smoking cessation programs should start immediately, during hospitalization, after acute MI, CABG, PCI, and vascular surgery.”

Reference:
Am Heart J 2008;156:473-476.