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Smokeless tobacco, snus, at admission for percutaneous coronary intervention and future risk for cardiac events

Frobert, Ole ; Reitan, Christian LU ; Hatsukami, Dorothy K. ; Pernow, John ; Omerovic, Elmir and Andell, Pontus LU (2019) In Open Heart 6(2).
Abstract

Objective To assess the risk of future death and cardiac events following percutaneous coronary intervention (PCI) in patients using smokeless tobacco, snus, compared with patients not using snus at admission for a first PCI. Methods The Swedish Coronary Angiography and Angioplasty Registry is a prospective registry on coronary diagnostic procedures and interventions. A total of 74 958 patients admitted for a first PCI were enrolled between 2009 and 2018, 6790 snus users and 68 168 not using snus. We used Cox proportional hazards regression for statistical modelling on imputed datasets as well as complete-case datasets. Results Patients using snus were younger (mean (SD) age 61.0 (±10.2) years) than patients not using snus (67.6... (More)

Objective To assess the risk of future death and cardiac events following percutaneous coronary intervention (PCI) in patients using smokeless tobacco, snus, compared with patients not using snus at admission for a first PCI. Methods The Swedish Coronary Angiography and Angioplasty Registry is a prospective registry on coronary diagnostic procedures and interventions. A total of 74 958 patients admitted for a first PCI were enrolled between 2009 and 2018, 6790 snus users and 68 168 not using snus. We used Cox proportional hazards regression for statistical modelling on imputed datasets as well as complete-case datasets. Results Patients using snus were younger (mean (SD) age 61.0 (±10.2) years) than patients not using snus (67.6 (±11.1), p<0.001) and more often male (95.4% vs 67.4%, p<0.001). After multivariable adjustment, snus use was not associated with the primary composite outcome of all-cause mortality, new coronary revascularisation or new hospitalisation for heart failure at 1 year (HR 0.98, 95% CI 0.91 to 1.05). In patients using snus at baseline who underwent a second PCI (n=1443), the duration from the index intervention was shorter for subjects who continued using snus (n=921, 63.8%) compared with subjects who had stopped (mean number of days 285 vs 406, p value=0.001). Conclusions Snus use at admission for a first PCI was not associated with a higher occurrence of all-cause mortality, new revascularisation or heart failure hospitalisation. Discontinuing snus after a first PCI was associated with a significantly longer duration to a subsequent PCI.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
myocardial infarction, percutaneous coronary intervention, smokeless tobacco, snus
in
Open Heart
volume
6
issue
2
article number
e001109
publisher
BMJ Publishing Group
external identifiers
  • pmid:31673392
  • scopus:85073683697
ISSN
2398-595X
DOI
10.1136/openhrt-2019-001109
language
English
LU publication?
yes
id
b314675d-c8de-459b-b22c-b7afcb72bcaf
date added to LUP
2019-11-05 08:48:20
date last changed
2020-07-08 05:06:45
@article{b314675d-c8de-459b-b22c-b7afcb72bcaf,
  abstract     = {<p>Objective To assess the risk of future death and cardiac events following percutaneous coronary intervention (PCI) in patients using smokeless tobacco, snus, compared with patients not using snus at admission for a first PCI. Methods The Swedish Coronary Angiography and Angioplasty Registry is a prospective registry on coronary diagnostic procedures and interventions. A total of 74 958 patients admitted for a first PCI were enrolled between 2009 and 2018, 6790 snus users and 68 168 not using snus. We used Cox proportional hazards regression for statistical modelling on imputed datasets as well as complete-case datasets. Results Patients using snus were younger (mean (SD) age 61.0 (±10.2) years) than patients not using snus (67.6 (±11.1), p&lt;0.001) and more often male (95.4% vs 67.4%, p&lt;0.001). After multivariable adjustment, snus use was not associated with the primary composite outcome of all-cause mortality, new coronary revascularisation or new hospitalisation for heart failure at 1 year (HR 0.98, 95% CI 0.91 to 1.05). In patients using snus at baseline who underwent a second PCI (n=1443), the duration from the index intervention was shorter for subjects who continued using snus (n=921, 63.8%) compared with subjects who had stopped (mean number of days 285 vs 406, p value=0.001). Conclusions Snus use at admission for a first PCI was not associated with a higher occurrence of all-cause mortality, new revascularisation or heart failure hospitalisation. Discontinuing snus after a first PCI was associated with a significantly longer duration to a subsequent PCI.</p>},
  author       = {Frobert, Ole and Reitan, Christian and Hatsukami, Dorothy K. and Pernow, John and Omerovic, Elmir and Andell, Pontus},
  issn         = {2398-595X},
  language     = {eng},
  number       = {2},
  publisher    = {BMJ Publishing Group},
  series       = {Open Heart},
  title        = {Smokeless tobacco, snus, at admission for percutaneous coronary intervention and future risk for cardiac events},
  url          = {http://dx.doi.org/10.1136/openhrt-2019-001109},
  doi          = {10.1136/openhrt-2019-001109},
  volume       = {6},
  year         = {2019},
}