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Date of download: 6/21/2016 Copyright © The American College of Cardiology. All rights reserved. From: Smoking Is Associated With Adverse Clinical Outcomes.

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Presentation on theme: "Date of download: 6/21/2016 Copyright © The American College of Cardiology. All rights reserved. From: Smoking Is Associated With Adverse Clinical Outcomes."— Presentation transcript:

1 Date of download: 6/21/2016 Copyright © The American College of Cardiology. All rights reserved. From: Smoking Is Associated With Adverse Clinical Outcomes in Patients Undergoing Revascularization With PCI or CABG: The SYNTAX Trial at 5-Year Follow-Up J Am Coll Cardiol. 2015;65(11):1107-1115. doi:10.1016/j.jacc.2015.01.014 Smoking Status of Patients in the SYNTAX Trial at 5-Year Follow-Up The smoking status of patients stratified into smokers, ex-smokers, and nonsmokers is displayed for overall SYNTAX (SYNergy Between PCI With TAXUS and Cardiac Surgery) trial patients as well as coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) arms. While the proportion of nonsmokers remained constant, there were changes in proportion of smokers and ex-smokers, as nearly half of smokers stopped smoking after the index procedure but some relapsed during follow-up. Ex-smoker was defined as a smoker quitting more than 1 month before the index procedure or follow-up time point. Figure Legend:

2 Date of download: 6/21/2016 Copyright © The American College of Cardiology. All rights reserved. From: Smoking Is Associated With Adverse Clinical Outcomes in Patients Undergoing Revascularization With PCI or CABG: The SYNTAX Trial at 5-Year Follow-Up J Am Coll Cardiol. 2015;65(11):1107-1115. doi:10.1016/j.jacc.2015.01.014 Kaplan-Meier Cumulative Events for Primary Endpoint and MACCE (A) The baseline smoking status (current smoker vs. ex-smoker vs. nonsmoker) appeared to have no impact on death/myocardial infarction (MI)/stroke (primary endpoint) and major adverse cardiac and cerebrovascular events (MACCE) (defined as a combination of death/MI/stroke and target lesion revascularization) at 5-year follow-up. (B) Analyzing the data for those smoking or not smoking at baseline also yielded similar results. (C) However, using smoking status as a time-dependent covariate at follow-up, smoking was associated with an increased risk of death/MI/stroke and MACCE at final 5-year follow-up. The hazard ratio with 95% confidence interval was calculated for outcomes at different follow-up time points. The beneficial effect of nonsmoking, although less pronounced within the short term, was maintained throughout 5-year follow-up. Figure Legend:

3 Date of download: 6/21/2016 Copyright © The American College of Cardiology. All rights reserved. From: Smoking Is Associated With Adverse Clinical Outcomes in Patients Undergoing Revascularization With PCI or CABG: The SYNTAX Trial at 5-Year Follow-Up J Am Coll Cardiol. 2015;65(11):1107-1115. doi:10.1016/j.jacc.2015.01.014 Association of Smoking Status With Clinical Outcomes at 5 Years This forest plot shows clinical outcomes according to smoking status (as a time-dependent covariate) in the overall SYNTAX (SYNergy Between PCI With TAXUS and Cardiac Surgery) trial population and 2 revascularization strategies. A nonsignificant p value for interaction indicates that the hazard ratio (HR) of smoking versus not smoking remained similar across the respective percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) subgroups. CI = confidence interval; GO = graft occlusion; ST = stent thrombosis. Figure Legend:

4 Date of download: 6/21/2016 Copyright © The American College of Cardiology. All rights reserved. From: Smoking Is Associated With Adverse Clinical Outcomes in Patients Undergoing Revascularization With PCI or CABG: The SYNTAX Trial at 5-Year Follow-Up J Am Coll Cardiol. 2015;65(11):1107-1115. doi:10.1016/j.jacc.2015.01.014 Smoking Associated With Poor Clinical Outcomes: Adjusted Kaplan-Meier Cumulative Events for Primary Endpoint and MACCE (A) After adjusting for confounding variables, baseline smoking status (current smoker vs. ex-smoker vs. nonsmoker) appeared to have no impact on major adverse cardiac and cerebrovascular events (MACCE) (defined as a combination of death/myocardial infarction [MI]/stroke and target lesion revascularization), but current smokers had significantly higher rate of death/MI/stroke (the primary endpoint) at 5-year follow-up. (B) Analyzing the data for those smoking or not smoking at baseline yielded similar results. (C) Using smoking status as a time-dependent covariate at follow-up after adjusting baseline characteristics, nonsmoking significantly lowered the risk of death/MI/stroke and MACCE at final 5-year follow-up. Hazard ratios with 95% confidence intervals were calculated for outcomes at different follow-up time points. Figure Legend:


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