Quit smoking improves angioplasty outcomes

Patients who quit smoking at the time of undergoing angioplasty - a nonsurgical procedure used to improve blood flow to the heart - may benefit much more from the procedure than those who continue to smoke. This is according to a new study published in the journal Circulation: Cardiovascular Interventions.

Patients who quit smoking when undergoing angioplasty reported better quality of life and were less likely to experience chest pain than those who carried on smoking.

Patients with atherosclerosis - an accumulation of fatty plaques in the blood vessels of the heart - may be required to undergo angioplasty if medications or lifestyle changes fail to improve heart health enough, or if a patient suffers a heart attack or chest pain as a result of their condition.
The procedure involves the insertion of a thin tube into an artery in the arm or the groin, which is threaded to the coronary arteries. The tube has a small balloon on the end, which is inflated to push any plaque against the wall of the artery. This relieves the blockage and improves blood flow.
During angioplasty, a small mesh tube called a stent is normally inserted, which expands and fixes to the artery wall as the balloon inflates. This stent reduces the likelihood of the artery becoming blocked again.
Each year, around 1 million adults in the US undergo angioplasty. In this latest study, senior author Dr. John Spertus, clinical director of outcomes research at Saint Luke's Mid America Heart Institute in Kansas City, MO, and colleagues set out to see how quitting smoking affected patients' quality of life and chest pain following angioplasty.

The team recruited 2,765 adults from 10 hospitals across the US who were undergoing angioplasty for either heart attack or chest pain. Patients were then allocated to one of four groups: those who had never smoked, past smokers who quit before angioplasty, those who smoked but quit at the time of angioplasty, and those who continued to smoke after angioplasty. The patients were asked to complete a questionnaire at the time of angioplasty, which gathered information on their chest pain and overall quality of life. This questionnaire was completed again at 1, 6 and 12 months after the procedure.

Compared with patients who continued to smoke after angioplasty, those who quit the habit reported a better overall quality of life at 1 year after the procedure.
What is more, 21% of patients who quit smoking at the time of angioplasty continued to experience chest pain, compared with 31% who carried on smoking. Nineteen percent of patients who had never smoked or quit smoking before angioplasty continued to experience chest pain.
Commenting on the findings, Dr. Spertus says:
"It's a no-brainer. Stopping smoking seems like a relatively easy way to increase your chances of getting the best outcomes from angioplasty."


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