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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
Publication Date
Document Type

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.

  • UMCCTS funding
DOI of Published Version

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

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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)
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