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Smoking cessation and outcome after ischemic stroke or TIA
- Source :
- Department of Medicine Publications
- Publication Year :
- 2017
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2017.
-
Abstract
- Objective:To assess whether smoking cessation after an ischemic stroke or TIA improves outcomes compared to continued smoking.Methods:We conducted a prospective observational cohort study of 3,876 nondiabetic men and women enrolled in the Insulin Resistance Intervention After Stroke (IRIS) trial who were randomized to pioglitazone or placebo within 180 days of a qualifying stroke or TIA and followed up for a median of 4.8 years. A tobacco use history was obtained at baseline and updated during annual interviews. The primary outcome, which was not prespecified in the IRIS protocol, was recurrent stroke, myocardial infarction (MI), or death. Cox regression models were used to assess the differences in stroke, MI, and death after 4.8 years, with correction for adjustment variables prespecified in the IRIS trial: age, sex, stroke (vs TIA) as index event, history of stroke, history of hypertension, history of coronary artery disease, and systolic and diastolic blood pressures.Results:At the time of their index event, 1,072 (28%) patients were current smokers. By the time of randomization, 450 (42%) patients had quit smoking. Among quitters, the 5-year risk of stroke, MI, or death was 15.7% compared to 22.6% for patients who continued to smoke (adjusted hazard ratio 0.66, 95% confidence interval 0.48–0.90).Conclusion:Cessation of cigarette smoking after an ischemic stroke or TIA was associated with significant health benefits over 4.8 years in the IRIS trial cohort.
- Subjects :
- Male
medicine.medical_specialty
medicine.medical_treatment
Myocardial Infarction
030204 cardiovascular system & hematology
Article
Cohort Studies
Coronary artery disease
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Humans
cardiovascular diseases
Myocardial infarction
Stroke
Aged
Proportional Hazards Models
Proportional hazards model
business.industry
Smoking
Hazard ratio
Middle Aged
medicine.disease
Ischemic Attack, Transient
Cohort
Physical therapy
Smoking cessation
Female
Smoking Cessation
Neurology (clinical)
business
030217 neurology & neurosurgery
Cohort study
Subjects
Details
- ISSN :
- 1526632X and 00283878
- Volume :
- 89
- Database :
- OpenAIRE
- Journal :
- Neurology
- Accession number :
- edsair.doi.dedup.....7da478d8679ed232f5549cec0731f8fe