Top

Health and Quality of Life Outcomes

Published in:

Open Access 01-01-2017 | Research

Impact of smoking on health-related quality of Life after percutaneous coronary intervention treated with drug-eluting stents: a longitudinal observational study

Authors: Chao Xue, Lin Bian, Yu Shui Xie, Zhao Fang Yin, Zuo Jun Xu, Qi Zhi Chen, Hui Li Zhang, Chang Qian Wang

Published in: Health and Quality of Life Outcomes | Issue 1/2017

Abstract

Background

Smoking has been shown to reduce health-related quality of life (HRQOL) in patients with coronary artery disease (CAD) undergoing percutanous coronary intervention (PCI) either by means of balloon angioplasty or with the use of bare-metal stents (BMS). Drug-eluting stents (DES) have now been widely used and are related to substantial reduction of restenosis and significantly improved HRQOL compared with BMS. This study aimed to evaluate the effects of smoking on HRQOL in patients after PCI in DES era.

Methods

A cohort of 649 patients admitted for CAD and treated with drug-eluting stents were included in this prospective, observational study. Patients were classified as non-smokers (n = 351, 54.1%), quitters (n = 126, 19,4%), or persistent smokers (n = 172, 26.5%) according to their smoking status at the time they first admitted to hospital and during the first year of follow-up. Each patient was prospectively interviewed at baseline, 6 months and 1 year following PCI. HRQOL was assessed with the use of Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36).

Results

For the overall population, HRQOL scores at 1-year follow-up were significantly higher than baseline for all 8 domains. At 1-year follow-up, the HRQOL scores in persistent smokers were still lower than that in non-smokers in 6 domains except for bodily pain and mental health, and than that in quitters in 5 domains except for bodily pain, role emotional and mental health. There were no significant differences with regard to the scores between non-smokers and quitters except role emotional for which non-smokers had higher scores. After adjustment, persistent smokers demonstrated significantly less improvements in HRQOL than non-smokers in 6 domains except for bodily pain and social functioning and significantly less improvement than quitters for general health. Improvements of quitters were comparable to that of non-smokers in all domains. Multivariate linear regression analyses showed persistent smoking was an independent risk factor for PCS and MCS improvements.

Conclusions

Persistent smoking substantially diminishes the potential quality-of-life benefits of DES. Efforts should be made to promote smoking cessation after DES implantation which could greatly improve the health quality outcomes.

Smith Jr SC, Dove JT, Jacobs AK, Kennedy JW, Kereiakes D, Kern MJ, Kuntz RE, Popma JJ, Schaff HV, Williams DO, Gibbons RJ, Alpert JP, Eagle KA, Faxon DP, Fuster V, Gardner TJ, Gregoratos G, Russell RO, Smith Jr SC, American College of Cardiology, American Heart Association Task Force on Practice Guidelines. Committee to revise the 1993 guidelines for percutaneous transluminal coronary angioplasty. ACC/AHA guidelines of percutaneous coronary interventions (revision of the 1993 PTCA guidelines)--executive summary. A report of the american college of cardiology/american heart association task force on practice guidelines (committee to revise the 1993 guidelines for percutaneous transluminal coronary angioplasty). J Am Coll Cardiol. 2001;37(8):2215–39.CrossRefPubMed

Morice MC, Serruys PW, Sousa JE, Fajadet J, Ban Hayashi E, Perin M, Colombo A, Schuler G, Barragan P, Guagliumi G, Molnàr F, Falotico R, RAVEL Study Group. Randomized study with the Sirolimus-coated Bx velocity balloon-expandable stent in the treatment of patients with de novo native coronary artery lesions. A randomized comparison of a sirolimus-eluting stent with a standard stent for coronary revascularization. N Engl J Med. 2002;346(23):1773–80.CrossRefPubMed

Holmes Jr DR, Leon MB, Moses JW, Popma JJ, Cutlip D, Fitzgerald PJ, Brown C, Fischell T, Wong SC, Midei M, Snead D, Kuntz RE. Analysis of 1-year clinical outcomes in the SIRIUS trial: a randomized trial of a sirolimus-eluting stent versus a standard stent in patients at high risk for coronary restenosis. Circulation. 2004;109(5):634–40.CrossRefPubMed

Spertus JA, Jones P, McDonell M, Fan V, Fihn SD. Health status predicts long-term outcome in outpatients with coronary disease. Circulation. 2002;106(1):43–9.CrossRefPubMed

Soto GE, Jones P, Weintraub WS, Krumholz HM, Spertus JA. Prognostic value of health status in patients with heart failure after acute myocardial infarction. Circulation. 2004;110(5):546–51.CrossRefPubMed

Krumholz HM, Peterson ED, Ayanian JZ, Chin MH, DeBusk RF, Goldman L, Kiefe CI, Powe NR, Rumsfeld JS, Spertus JA, Weintraub WS, National Heart, Lung, and Blood Institute working group. Report of the national heart, lung, and blood institute working group on outcomes research in cardiovascular disease. Circulation. 2005;111(23):3158–66.CrossRefPubMed

Hasdai D, Garratt KN, Grill DE, Lerman A, Holmes Jr DR. Effect of smoking status on the long-term outcome after successful percutaneous coronary revascularization. N Engl J Med. 1997;336(11):755–61.CrossRefPubMed

Ware Jr JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473–83.CrossRefPubMed

Yagi H, Komukai K, Hashimoto K, Kawai M, Ogawa T, Anzawa R, Minai K, Nagoshi T, Ogawa K, Taniguchi I, Yoshimura M. Difference in risk factors between acute coronary syndrome and stable angina pectoris in the Japanese: smoking as a crucial risk factor of acute coronary syndrome. J Cardiol. 2010;55(3):345–53.CrossRefPubMed

10.

Weisz G, Cox DA, Garcia E, Tcheng JE, Griffin JJ, Guagliumi G, Stuckey TD, Rutherford BD, Mehran R, Aymong E, Lansky A, Grines CL, Stone GW. Impact of smoking status on outcomes of primary coronary intervention for acute myocardial infarction--the smoker’s paradox revisited. Am Heart J. 2005;150(2):358–64.CrossRefPubMed

11.

D’Agostino Jr RB. Propensity scores in cardiovascular research. Circulation. 2007;115(17):2340–3.CrossRefPubMed

12.

D’Agostino Jr RB. Propensity score methods for bias reduction in the comparison of a treatment to a non-randomized control group. Stat Med. 1998;17(19):2265–81.CrossRefPubMed

13.

Spertus JA, Salisbury AC, Jones PG, Conaway DG, Thompson RC. Predictors of quality-of-life benefit after percutaneous coronary intervention. Circulation. 2004;110(25):3789–94.CrossRefPubMed

14.

Kim J, Henderson RA, Pocock SJ, Clayton T, Sculpher MJ, Fox KA, RITA-3 Trial Investigators. Health-related quality of life after interventional or conservative strategy in patients with unstable angina or non-ST-segment elevation myocardial infarction: one-year results of the third Randomized Intervention Trial of unstable Angina (RITA-3). J Am Coll Cardiol. 2005;45(2):221–8.CrossRefPubMed

15.

Rinfret S, Grines CL, Cosgrove RS, Ho KK, Cox DA, Brodie BR, Morice MC, Stone GW, Cohen DJ, Stent-PAMI Investigators. Quality of life after balloon angioplasty or stenting for acute myocardial infarction. One-year results from the Stent-PAMI trial. J Am Coll Cardiol. 2001;38(6):1614–21.CrossRefPubMed

16.

Nash IS, Curtis LH, Rubin H. Predictors of patient-reported physical and mental health 6 months after percutaneous coronary revascularization. Am Heart J. 1999;138(3 Pt 1):422–9.CrossRefPubMed

17.

Cohen DJ, Van Hout B, Serruys PW, Mohr FW, Macaya C, den Heijer P, Vrakking MM, Wang K, Mahoney EM, Audi S, Leadley K, Dawkins KD, Kappetein AP, Synergy between PCI with Taxus and Cardiac Surgery Investigators. Quality of life after PCI with drug-eluting stents or coronary-artery bypass surgery. N Engl J Med. 2011;364(11):1016–26.CrossRefPubMed

18.

van Domburg RT, Daemen J, Morice MC, de Bruyne B, Colombo A, Macaya C, Richardt G, Fajadet J, Hamm C, van Es GA, Wittebols K, Macours N, Stoll HP, Serruys PW. Short- and long-term health related quality-of-life and anginal status of the arterial Revascularisation therapies study part II, ARTS-II; sirolimus-eluting stents for the treatment of patients with multivessel coronary artery disease. EuroIntervention. 2010;5(8):962–7.CrossRefPubMed

19.

Tillmann M, Silcock J. A comparison of smokers’ and ex-smokers’ health-related quality of life. J Public Health Med. 1997;19(3):268–73.CrossRefPubMed

20.

Hirdes JP, Maxwell CJ. Smoking cessation and quality of life outcomes among older adults in the Campbell’s survey on well-being. Can J Public Health. 1994;85(2):99–102.PubMed

21.

Taira DA, Seto TB, Ho KK, Krumholz HM, Cutlip DE, Berezin R, Kuntz RE, Cohen DJ. Impact of smoking on health-related quality of life after percutaneous coronary revascularization. Circulation. 2000;102(12):1369–74.CrossRefPubMed

22.

Jang JS, Buchanan DM, Gosch KL, Jones PG, Sharma PK, Shafiq A, Grodzinsky A, Fendler TJ, Graham G, Spertus JA. Association of smoking status with health-related outcomes after percutaneous coronary intervention. Circ Cardiovasc Interv. 2015;8(5):e002226.CrossRefPubMed

23.

Samet JM. The 1990 report of the surgeon general: the health benefits of smoking cessation. Am Rev Respir Dis. 1990;142(5):993–4.CrossRefPubMed

24.

Critchley JA, Capewell S. Mortality risk reduction associated with smoking cessation in patients with coronary heart disease: a systematic review. JAMA. 2003;290(1):86–97.CrossRefPubMed

25.

Buchanan DM, Arnold SV, Gosch KL, Jones PG, Longmore LS, Spertus JA, Cresci S. Association of smoking status with angina and health-related quality of life after acute myocardial infarction. Circ Cardiovasc Qual Outcomes. 2015;8(5):493–500.CrossRefPubMedPubMedCentral

Title: Impact of smoking on health-related quality of Life after percutaneous coronary intervention treated with drug-eluting stents: a longitudinal observational study
Authors: Chao Xue
Lin Bian
Yu Shui Xie
Zhao Fang Yin
Zuo Jun Xu
Qi Zhi Chen
Hui Li Zhang
Chang Qian Wang
Publication date: 01-01-2017
Publisher: BioMed Central
Published in: Health and Quality of Life Outcomes / Issue 1/2017
Electronic ISSN: 1477-7525
DOI: https://doi.org/10.1186/s12955-016-0578-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Impact of smoking on health-related quality of Life after percutaneous coronary intervention treated with drug-eluting stents: a longitudinal observational study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2017

Feasibility of the Participation and Activity Inventory for Children and Youth (PAI-CY) and Young Adults (PAI-YA) with a visual impairment: a pilot study

Patient-reported health-related quality of life, work productivity, and activity impairment during treatment with ALO-02 (extended-release oxycodone and sequestered naltrexone) for moderate-to-severe chronic low back pain

“Fibromyalgia and quality of life: mapping the revised fibromyalgia impact questionnaire to the preference-based instruments”

Measurement properties and normative data for the Norwegian SF-36: results from a general population survey

Inflammatory bowel disease-specific health-related quality of life instruments: a systematic review of measurement properties

Effects of home-based long-term care services on caregiver health according to age