Quit Smoking to Cut Your Heart Risk by 50% – Reducing Doesn’t Help Much

quit smoking heart risk

Patients diagnosed with stable coronary artery disease who cease smoking can significantly diminish their risk of major cardiovascular incidents by nearly 50%.

Research unveiled at the ESC Congress 2024 highlights that individuals with stable coronary artery disease who quit smoking at any juncture post-diagnosis reduced their risk of experiencing a major cardiovascular event by nearly half. In stark contrast, patients who merely cut back on smoking observed minimal impact on their cardiovascular risk.

Insights from the CLARIFY Registry

The global CLARIFY registry (prospeCtive observationaL LongitudInAl RegIstry oF patients with stable coronary arterY disease) meticulously evaluated the correlation between smoking status and cardiovascular events in patients suffering from coronary artery disease. The registry encompassed a cohort of 32,378 patients.

Over a 5-year follow-up period, researchers analyzed the incidence of a major adverse cardiovascular event (MACE), defined as cardiovascular death or myocardial infarction.

Critical Period for Smoking Cessation

Participants entered the study approximately 6.5 years after their coronary artery disease diagnosis. At the outset, 13,366 patients (41.3%) had never smoked, 14,973 (46.2%) were ex-smokers, and 4,039 (12.5%) were current smokers. Among the former smokers who had smoked at the time of their diagnosis, 72.8% quit within the subsequent year, while a mere 27.2% ceased smoking in the years that followed.

“Remarkably, the first year following diagnosis emerged as a pivotal period for cessation. It is during this time that we must emphasize the urgency of quitting and offer robust support to patients,” stated Dr. Jules Mesnier of Hospital Bichat-Claude Bernard, Paris, France.

Enduring Advantages of Quitting Smoking

Patients who abandoned smoking after their coronary artery disease diagnosis witnessed a substantial improvement in their cardiovascular outcomes, regardless of the timing of cessation.

They experienced a 44% reduction in the risk of MACE (adjusted hazard ratio [HR] 0.56; 95% confidence interval [CI] 0.42–0.76; p<0.001).

For those who merely reduced their smoking, the risk of MACE did not differ significantly compared to those who maintained their smoking habits (adjusted HR 0.96; 95% CI 0.74–1.26; p=0.78).

Moreover, the risk of MACE increased by 8% for each additional year of continued smoking after a coronary artery disease diagnosis (adjusted HR 1.08; 95% CI 1.04–1.12 per year).

Although those who quit smoking achieved a marked reduction in MACE risk compared to ongoing smokers, they never quite reached the cardiovascular risk level of individuals who had never smoked, even after years of cessation.

Dr. Mesnier concluded: “It is vital to convey to patients that it is never too early or too late to quit smoking; however, the sooner they do, the better their chances of reducing cardiovascular risk. Simply cutting down is insufficient.

Clear, concise messages are essential during every medical interaction to underscore the importance of quitting. Informing patients that they can halve their risk of a major event or death, as demonstrated in our study, is a compelling message.”

Strategies to promote smoking cessation include brief advice, counseling, behavioral interventions, and pharmacotherapy.

quit smoking heart risk

References

The abstract “Trajectories in smoking habits and outcomes in patients with stable coronary artery disease” will be presented during the session ‘Epidemiology and risk factors in cardiovascular disease’ on Friday, 30 August 2024, at 11:35 BST at Station 3.

Reference: “2021 ESC Guidelines on cardiovascular disease prevention in clinical practice: Developed by the Task Force for cardiovascular disease prevention in clinical practice with representatives of the European Society of Cardiology and 12 medical societies With the special contribution of the European Association of Preventive Cardiology (EAPC)” by Frank L J Visseren, François Mach, Yvo M Smulders, David Carballo, Konstantinos C Koskinas, Maria Bäck, Athanase Benetos, Alessandro Biffi, José-Manuel Boavida, Davide Capodanno, Bernard Cosyns, Carolyn Crawford, Constantinos H Davos, Ileana Desormais, Emanuele Di Angelantonio, Oscar H Franco, Sigrun Halvorsen, F D Richard Hobbs, Monika Hollander, Ewa A Jankowska, Matthias Michal, Simona Sacco, Naveed Sattar, Lale Tokgozoglu, Serena Tonstad, Konstantinos P Tsioufis, Ineke van Dis, Isabelle C van Gelder, Christoph Wanner, Bryan Williams, ESC Scientific Document Group, Guy De Backer, Vera Regitz-Zagrosek, Anne Hege Aamodt, Magdy Abdelhamid, Victor Aboyans, Christian Albus, Riccardo Asteggiano, Magnus Bäck, Michael A Borger, Carlos Brotons, Jelena Čelutkienė, Renata Cifkova, Maja Cikes, Francesco Cosentino, Nikolaos Dagres, Tine De Backer, Dirk De Bacquer, Victoria Delgado, Hester Den Ruijter, Paul Dendale, Heinz Drexel, Volkmar Falk, Laurent Fauchier, Brian A Ference, Jean Ferrières, Marc Ferrini, Miles Fisher, Danilo Fliser, Zlatko Fras, Dan Gaita, Simona Giampaoli, Stephan Gielen, Ian Graham, Catriona Jennings, Torben Jorgensen, Alexandra Kautzky-Willer, Maryam Kavousi, Wolfgang Koenig, Aleksandra Konradi, Dipak Kotecha, Ulf Landmesser, Madalena Lettino, Basil S Lewis, Aleš Linhart, Maja-Lisa Løchen, Konstantinos Makrilakis, Giuseppe Mancia, Pedro Marques-Vidal, John William McEvoy, Paul McGreavy, Bela Merkely, Lis Neubeck, Jens Cosedis Nielsen, Joep Perk, Steffen E Petersen, Anna Sonia Petronio, Massimo Piepoli, Nana Goar Pogosova, Eva Irene Bossano Prescott, Kausik K Ray, Zeljko Reiner, Dimitrios J Richter, Lars Rydén, Evgeny Shlyakhto, Marta Sitges, Miguel Sousa-Uva, Isabella Sudano, Monica Tiberi, Rhian M Touyz, Andrea Ungar, W M Monique Verschuren, Olov Wiklund, David Wood, Jose Luis Zamorano, Yvo M Smulders, David Carballo, Konstantinos C Koskinas, Maria Bäck, Athanase Benetos, Alessandro Biffi, José-Manuel Boavida, Davide Capodanno, Bernard Cosyns, Carolyn A Crawford, Constantinos H Davos, Ileana Desormais, Emanuele Di Angelantonio, Oscar H Franco Duran, Sigrun Halvorsen, F D Richard Hobbs, Monika Hollander, Ewa A Jankowska, Matthias Michal, Simona Sacco, Naveed Sattar, Lale Tokgozoglu, Serena Tonstad, Konstantinos P Tsioufis, Ineke van Dis, Isabelle C van Gelder, Christoph Wanner and Bryan Williams, 30 August 2021, European Heart Journal. DOI: 10.1093/eurheartj/ehab484.