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Smoking status and life expectancy after acute myocardial infarction in the elderly
University of Massachusetts Medical School Faculty Publications
  • Emily M. Bucholz, Boston Children's Hospital
  • Adam L. Beckman, Yale University
  • Catarina I. Kiefe, University of Massachusetts Medical School
  • Harlan M. Krumholz, Yale University
UMMS Affiliation
Department of Quantitative Health Sciences
Date
1-15-2016
Document Type
Article
Abstract

OBJECTIVE: Smokers have lower short-term mortality after acute myocardial infarction (AMI) than non-smokers; however, little is known about the long-term effects of smoking on life expectancy after AMI. This study aimed to quantify the burden of smoking after AMI using life expectancy and years of life lost.

METHODS: We analysed data from the Cooperative Cardiovascular Project, a medical record study of 158 349 elderly Medicare patients with AMI and over 17 years of follow-up, to evaluate the age-specific association of smoking with life expectancy and years of life lost after AMI.

RESULTS: Our sample included 23 447 (14.8%) current smokers. Current smokers had lower crude mortality up to 5 years, which was largely explained by their younger age at AMI. After adjustment other patient characteristics, smoking was associated with lower 30-day (HR 0.91, 95% CI 0.87 to 0.94) but higher long-term mortality (17-year HR 1.19, 95% CI 1.17 to 1.20) after AMI. Overall, crude life expectancy estimates were lower for current smokers than non-smokers at all ages, which translated into sizeable numbers of life-years lost attributable to smoking. As age at AMI increased, the magnitude of life-years lost due to smoking decreased. After full risk adjustment, the differences in life expectancy between current smokers and non-smokers persisted at all ages.

CONCLUSIONS: Current smoking is associated with lower life expectancy and large numbers of life-years lost after AMI. Our findings lend additional support to smoking cessation efforts after AMI.

Rights and Permissions
Citation: Heart. 2016 Jan 15;102(2):133-9. doi: 10.1136/heartjnl-2015-308263. Epub 2015 Nov 23. Link to article on publisher's site
Related Resources
Link to Article in PubMed
Keywords
  • UMCCTS funding
PubMed ID
26596792
Citation Information
Emily M. Bucholz, Adam L. Beckman, Catarina I. Kiefe and Harlan M. Krumholz. "Smoking status and life expectancy after acute myocardial infarction in the elderly" Vol. 102 Iss. 2 (2016) ISSN: 1355-6037 (Linking)
Available at: http://works.bepress.com/catarina_kiefe/245/