IMPACT OF SMOKING ON OUTCOMES OF PERCUTANEOUS CORONARY INTERVENTION IN PAKISTANI PATIENTS WITH CORONARY ARTERY DISEASE
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Keywords
Coronary artery disease, Percutaneous Coronary Intervention,, Smoking, Major adverse cardiovascular events, Left ventricular ejection fraction, Pakistan
Abstract
Background: Coronary artery disease (CAD) is a leading cause of morbidity and mortality globally, particularly in developing countries like Pakistan. Percutaneous Coronary Intervention (PCI) is a common and effective treatment for CAD. However, smoking, a major risk factor for CAD, adversely impacts PCI outcomes.
Objective: This study aimed to evaluate the impact of smoking on the outcomes of PCI in Pakistani patients with CAD.
Methods: An observational cohort study was conducted at the National Institute of Cardiovascular Diseases (NICVD) in Karachi, Pakistan, from January 2020 to December 2022. The study included 303 patients who underwent PCI. Participants were categorized into smokers and non-smokers. Data on baseline characteristics, major adverse cardiovascular events (MACE), and left ventricular ejection fraction (LVEF) were collected. Statistical analysis was performed using SPSS version 25.0.
Results: The study population comprised 203 males (67%) and 100 females (33%), with a mean age of 60.4 years. Smokers had a significantly higher incidence of MACE (24.8%) compared to non-smokers (17.1%) (p < 0.05). Additionally, smokers exhibited higher rates of myocardial infarction (15.9% vs. 9.5%), target vessel revascularization (13.1% vs. 8.2%), and cardiovascular death (7.6% vs. 4.4%) (p < 0.05 for all). Smokers also had a lower mean LVEF Post-PCI (52.3% vs. 55.7%) (p < 0.05).
Conclusion: Smoking significantly worsens PCI outcomes in patients with CAD in Pakistan. These findings underscore the importance of integrating aggressive smoking cessation programs into the management of patients undergoing PCI to improve clinical outcomes.
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Dr Khair ul Bashar
Resident Cardiologist, National Institute of Cardiovascular Diseases, KarachiDr Mishal
Postgraduate Resident Cardiology, National Institute of Cardiovascular Diseases, Karachi
Dr Sandeep Kumar
Post-graduate Trainee (FCPS Adult Cardiology), National Institute of Cardiovascular Diseases, Karachi
Dr Sana Tanveer
Resident Cardiology, National Institute of Cardiovascular Diseases, Karachi
Dr.Muntaha Irshad
FCPS Resident Cardiology, National Institute of Cardiovascular Diseases, Karachi
Dr. Atta ur Rehman (Saleem)
Resident Adult Cardiology, National Institute of Cardiovascular Diseases, Karachi
Dr Muhammad Kamran Khan
Resident Adult Cardiology, National Institute of Cardiovascular Diseases, Karachi