Characteristics of Coronary Artery Lesions in Smokers With Coronary Heart Disease and Prognostic Evaluation After Percutaneous Coronary Intervention / 中国循环杂志

ABSTRACT

Objectives: To investigate the characteristics of coronary lesions and evaluate the prognosis post-percutaneous coronary intervention(PCI)in smokers with coronary heart disease. Methods: The data were derived from PANDA III, which was a perspective, multi-center, "all-comer", randomized controlled trial. Between Dec. 2013 and Aug. 2014, 2 348 patients from 46 centers were enrolled. Mean age was (61.2 ±10.6) years old, 1 658 patients (70.6%) were male. All the patients underwent PCI and biodegradable polymer drug eluting stents were implanted as indicated. Patients were divided into non-smoking group, quitter group and smoking-group based on the basis of smoking status at baseline. Primary endpoint was major adverse cardiac events (MACE), including all-cause mortality, myocardial infarction and repeated revascularization. Secondary endpoint were stent thrombosis and target lesion failure (TLF), including cardiac death, target vessel myocardial infarction and ischemia driven target lesion revascularization. Results: Smokers and quitters were more often males. Compared with non-smoking group and quitter group, patients in smoking group were significantly younger (P<0.0001), proportion of hypertension (P=0.0002), diabetes mellitus (P=0.0052) and previous PCI history (P<0.0001) was significantly lower. The incidence of acute myocardial infarction in the smoking group was as high as 41.3% (363/879), which was significantly higher than that of the quitter group and non-smoking group (P<0.0001). A total of 1 130 (96.7%), 286 (95.3%) and 846 (96.2%) patients in the non-smoking group, quitter group and smoking-group completed the 2-year follow-up, respectively. The results of 2-years follow-up showed that MACE rate of non-smoking group, quitter group and smoking-group was 11.23%, 13.64% and 12.21%(P=0.54), respectively. Multivariable cox regression analysis indicated that smoking status was not an independent predictor for all-cause mortality and TLF.