Among Statin Users, Smoking Cessation Deserves Emphasis
More intense statin therapy does not appear to mitigate cardiovascular risk from smoking
THURSDAY, Feb. 3 (HealthDay News) -- Among patients taking statins for coronary heart disease (CHD), smokers are still more likely to suffer a major cardiovascular event (MCVE), when compared with nonsmokers, according to a study published in the Jan. 15 issue of The American Journal of Cardiology.
Paul Frey, M.D., of the University of California in San Francisco, and colleagues compared the risk of MCVEs, including cardiac death, myocardial infarction, stoke, or resuscitated cardiac arrest among participants on statins who were smokers, never-smokers, and ex-smokers. They pooled data from 18,885 patients in the Treating to New Targets and the Incremental Decrease in End Points through Aggressive Lipid Lowering trials, two studies which evaluated the efficacy of high-dose versus moderate-dose statin therapy in patients with CHD.
The researchers found that despite statin therapy, current smokers were 1.68 and 1.57 times more likely to experience a MCVE than never-smokers and ex-smokers, respectively. The rates of MCVE were increased for smokers compared with ex-smokers, and the differences between them were similar, regardless of intensity of statin therapy. The difference in absolute event rate between current and ex-smokers was found to be more than two times as large as the decrease in absolute event rate between high-dose and moderate-dose statin therapy. Smoking cessation was associated with a number needed to treat of 22 to prevent a MCVE over five years.
"Given the apparent magnitude of benefit from smoking cessation in patients with CHD despite modern medical therapy, smoking cessation deserves considerably more emphasis in secondary prevention," the authors write.