REVIEW ER 'S CONCLUSIONS Quitting smoking is associated with a substantial reduction in risk of all-cause mortality among patients with CHD .
This 36 % risk reduction appears substantial compared with other secondary preventive therapies such as cholesterol lowering which have received greater attention in recent years .
The risk reduction associated with quitting smoking seems consistent regardless of differences between the studies in terms of index cardiac events , age , sex , country , and time period .
BACKGROUND Although the importance of smoking as a risk factor for coronary heart disease is beyond doubt , the speed and magnitude of risk reduction when a smoker with coronary heart disease quits are still subjects of debate .
OBJECTIVES To estimate the magnitude of risk reduction when a patient with CHD stops smoking .
Reinfarction after thrombolytic therapy for acute myocardial infarction followed by conservative management: incidence and effect of smoking.
A group of 456 consecutive patients seen less than or equal to 6 h after the onset of acute myocardial infa rct ion associated with ST segment elevation received thrombolytic therapy and were followed up for 12 months . Intravenous streptokinase was given to 315 patients and recombinant tissue-type plasminogen activator ( rt-PA ) to 141 patients . Reinfa rct ion rate and risk factors for reinfa rct ion were assessed . Management after thrombolysis was conservative ; revascularization procedures were reserved for patients with symptoms refractory to medical therapy or for those with left main coronary artery stenosis .  Coronary artery surgery or angioplasty was performed in only 3.7 % of patients during the first 30 days after thrombolysis and in only 8.6 % by 1 year . Most patients ( 79 % ) underwent coronary arteriography . Twenty-six patients ( 5.7 % ) exhibited signs of threatened reinfa rct ion at 1 month after thrombolytic therapy as did 43 patients ( 9.4 % ) by 1 year . Reinfa rct ion was prevented in four of these patients by early readministration of thrombolytic therapy . Multivariate analysis of possible risk factors for reinfa rct ion identified at the time of initial infa rct ion showed current cigarette smoking to be the only predictive factor ( reinfa rct ion occurred in 12.5 % of smokers versus 6.3 % of nonsmokers , p = 0.04 ) . A second analysis of risk factors identified 3 weeks after initial infa rct ion , including the severity of residual stenosis at coronary arteriography and exercise test variables , again showed continued cigarette smoking to be the only factor predictive of reinfa rct ion . Twenty percent of patients who continued to smoke developed reinfa rct ion compared with 5.1 % of those who stopped ( p less than 0.01 ) . ( ABSTRACT TRUNCATED AT 250 WORDS
REVIEW ER 'S CONCLUSIONS Quitting smoking is associated with a substantial reduction in risk of all-cause mortality among patients with CHD .
This 36 % risk reduction appears substantial compared with other secondary preventive therapies such as cholesterol lowering which have received greater attention in recent years .
The risk reduction associated with quitting smoking seems consistent regardless of differences between the studies in terms of index cardiac events , age , sex , country , and time period .
BACKGROUND Although the importance of smoking as a risk factor for coronary heart disease is beyond doubt , the speed and magnitude of risk reduction when a smoker with coronary heart disease quits are still subjects of debate .
OBJECTIVES To estimate the magnitude of risk reduction when a patient with CHD stops smoking .