Smoking Status at Baseline and 10-Year Outcomes After Drug-Eluting Stent Implantation: Insights From the DECADE Cooperation.
Year: 2025
Type: article
Abstract: Background Studies investigating 10-year outcomes according to smoking status at baseline in a largescale population undergoing percutaneous coronary intervention (PCI) with drug-eluting stent (DES) implantation are scarce.Objectives The authors sought to assess the association between smoking status at baseline and 10-year outcomes after PCI with DES implantation.Methods We pooled individual participant data from 5 randomized trials including patients with 10-year follow-up after DES implantation. We divided participants into 2 groups as per smoking status at baseline. The main outcome was all-cause death. Secondary outcomes included cardiovascular death, myocardial infarction (MI), definite stent thrombosis (ST), and repeat revascularization (of target lesion, target vessel [TVR], or non-target vessel).Results A total of 9,527 patients undergoing PCI with DES implantation were included in this analysis (smoking n = 2,365, nonsmoking n = 7,162). After multivariable adjustment, smoking was associated with a higher risk of all-cause death (HRadj: 1.45; 95% CI: 1.33-1.59), cardiovascular death (HRadj: 1.59; 95% CI: 1.41-1.80), and definite ST (HRadj: 2.09; 95% CI: 1.34-3.26) over 10 years after PCI. The risk of MI was comparable in the first 30 days after PCI, but increased significantly from 1 to 10 years in the smoking group (HRadj: 1.60; 95% CI: 1.36-1.90). Smoking was associated with a lower risk of target lesion revascularization and target vessel revascularization, but a comparable risk of non-target vessel revascularization.Conclusions In patients undergoing PCI with DES, smoking at baseline is associated with an increased risk of death, MI, and ST, but a lower risk of repeat revascularization through to 10 years.
DOI: 10.48620/86588
Authors: Presch, Antonia, Coughlan, J J, Bär, Sarah, Brugaletta, Salvatore, Maeng, Michael, Kufner, Sebastian, Ortega-Paz, Luis, Räber, Lorenz, Laugwitz, Karl-Ludwig, Jensen, Lisette Okkels, Windecker, Stephan, Warnakula Olesen, Kevin Kris, Sabaté, Manel, Heg, Dik, Kastrati, Adnan, Cassese, Salvatore
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W6948066784
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