Young Heart Attack Victims Who Stop Smoking Reduce Mortality Risk Significantly

A new study in JAMA Network Open indicated that young individuals (aged 50 or younger) who experienced a heart attack had a reduced risk for mortality if they stopped smoking within a year of the event.

“Despite significant progress in primary prevention, the rate of myocardial infarction continues to increase in young adults,” the authors wrote in their abstract, noting that the purpose of the study was “to identify the prevalence of tobacco use and to examine the association of both smoking and smoking cessation with survival in a cohort of adults who experienced an initial MI at a young age.”

The data for the retrospective cohort analysis were drawn from the Partners YOUNG-MI registry, determining smoking status at time of presentation and at one year from participant electronic medical records. The study population included 2,072 individuals who had a myocardial infarction at 50 years of age or  younger between January 2000 and April 2016. Information on patient deaths was obtained from the Social Security Administration Death Master File, and other agencies. The researchers used propensity score-adjusted Cox proportional hazards modeling to evaluate the link between smoking cessation and all-cause and cardiovascular mortality.

According to the results, 1,669 participants were smokers at the time of index hospitalization. A cohort of 910 of those participants further broken down into a persistent smoking (n=343) group and a cessation group (n=567) after one year following myocardial infarction. Those who quite smoking showed a statistically significant reduction in the rate of all-cause mortality (HR=0.35; 95% CI, 0.19 to 0.63; P <0.001) and cardiovascular mortality (HR=0.29; 95% CI, 0.11 to 0.79; P=0.02). The associations remained statistically significant following propensity-score adjustment (HR=0.30; 95% CI, 0.16 to 0.56; P<0.001) for all-cause mortality and for cardiovascular mortality (HR=0.19; 95% CI, 0.06 to 0.56; P=0.003].

“Smoking cessation after myocardial infarction was associated with a clinically significant reduction in all-cause and cardiovascular mortality in a cohort of patients who experienced an myocardial infarction at a young age,” the authors wrote.

Smoking Cessation and Survival Among Young Adults With Myocardial Infarction https://t.co/5GhZq5zYLd #cardiology #cardiotwitter @JAMANetworkOpen @JAMACardio @JAMA_current

— Dr. Deepak L. Bhatt (@DLBHATTMD) July 8, 2020

Cohort study finds approximately 50% of patients in #YoungMI registry smoked; quitting post-MI was associated with ↓70% death & ↓80% CV death, yet 2/3 of patients continue smoking following discharge. https://t.co/Ys5NZcyTcY

— JAMA Network Open (@JAMANetworkOpen) July 8, 2020

A retrospective look at ~1000 folks with MIs age<50 who SMOKED. What percent after one year were still smoking? Having an MI is a come to Jesus moment. NIcotine is loathsome and vile.https://t.co/2FW7NQ3yLY

— Bradley Flansbaum (@BradleyFlansbau) July 8, 2020

Phenomenal work @DLBHATTMD showing substantial health benefits with smoking cessation after MI in young adults, with impressive all-cause and cardiovascular mortality reduction! Bravo! https://t.co/tonC8nkrZ8

— Ohad Oren, MD (@OhadOrenMD) July 9, 2020