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 .
Risk factors for a major coronary event after myocardial infarction in the Scandinavian Simvastatin Survival Study (4S). Impact of predicted risk on the benefit of cholesterol-lowering treatment.
AIMS To analyse ( 1 ) the prognostic importance of clinical findings and lipids in patients with a previous myocardial infa rct ion and ( 2 ) the relative and absolute benefit of simvastatin in patients at low , medium and high predicted risk . METHODS The 4S was a double-blind , r and omized , clinical trial of long-term treatment with simvastatin or matching placebo in patients with myocardial infa rct ion or angina pectoris , serum total cholesterol 5.5 - 8.0 mmol x l(-1 ) , and serum triglycerides < or=2.5 mmol x l(-1 ) . The present study only deals with those 3525 patients who had a previous myocardial infa rct ion . End-points comprised coronary death , definite and probable hospital verified myocardial infa rct ion , and resuscitated cardiac arrest . Because there were few women the primary analyses were performed among men . RESULTS A Cox model analysis in the placebo group identified the following independent predictors of coronary events : a history of hypertension ( P=0.023 ) , diabetes ( P=0.0001 ) , smoking after the myocardial infa rct ion ( P=0.010 ) , total cholesterol ( P=0.020 ) , and HDL cholesterol ( P=0.062 ) . The relative reduction of risk by simvastatin treatment in patients at low , medium and high predicted risk was 38 % , 39 % and 42 % , respectively , but the corresponding absolute benefit per 100 patients treated for 6 years increased from 7.9 to 16.2 . CONCLUSION In addition to serum lipids , clinical variables contributed significantly to prediction . The relative benefit from simvastatin treatment was independent of predicted risk , but the absolute benefit increased from low to high risk
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 .