Smoking cessation and outcome after ischemic stroke or TIA
2017; Lippincott Williams & Wilkins; Volume: 89; Issue: 16 Linguagem: Inglês
10.1212/wnl.0000000000004524
ISSN1526-632X
AutoresKatherine A. Epstein, Catherine M. Viscoli, J. David Spence, Lawrence H. Young, Silvio E. Inzucchi, Mark Gorman, Brett Gerstenhaber, Peter Guarino, Anand Dixit, Karen L. Furie, Walter N. Kernan, Christopher Bladin, Stephen C. Davis, Tissa Wijeratne, Christopher Levi, Mark Parsons, Amy Brodtmann, Steven Ng, John D. Archer, Candice Delcourt, Danilo Toni, Léo Berger, Jean‐Martin Boulanger, Richard Chan, J. David Spence, André Durocher, Ariane Mackey, Steve Verreault, Jeffrey Minuk, Andrew M. Penn, Ashfaq Shuaib, Robert Côté, Daniel Selchen, Neville Bayer, Margaret Sweet, Salim Malik, Grant Stotts, B. Griewing, Hassan Soda, Renate Weinhardt, Jörg Berrouschot, Anett Stoll, Otto W. Witte, Albrecht Günther, Ulf Bodechtel, Ulf Schminke, Carsten Hobohm, Andreas Hetzel, Johann Lambeck, Katja E. Wartenberg, Hagen B. Huttner, Ralf Dittrich, Darius G. Nabavi, Klaus Gröschel, Götz Thomalla, Michael Rosenkranz, Sebastian Jander, Andreas Meisel, Albert C. Ludolph, Katharina Althaus, Roman Huber, Matthias Lorenz, David Tanné, Oleg Merzlyak, Natan M. Bornstein, Gregory Telman, Yair Lampl, Jonathan Y. Streifler, Boaz Weller, Gal Ifergane, Y. Wirgin, Antonio Carolei, Danilo Toni, Paolo Stanzione, Giuseppe Micieli, Giancarlo Agnelli, Valeria Caso, Claudia Gandolfo, Giacomo P. Comi, Domenico Consoli, Maurizia Rasura, Vincenzo Di Lazzaro, Anand Dixit, Becky Jupp, Louise Shaw, Isam Salih, Bernard Esisi, Michael Power, W. David Strain, Salim Elyas, Dulka Manawadu, Lalit Kalra, Eoin O’Brien, Elizabeth A. Warburton, Kausik Chatterjee, David Hargroves, Adrian Blight, Barry Moynihan, Hugh S. Markus, Mary Joan Macleod, David Broughton, Helen Rodgers, Thant Hlaing, Scott Muir, Mahmud Sajid, Philip M. Bath, Christopher Price, Lakshmanan Sekaran, Djamil Vahidassr, Keith W. Muir, James McIlmoyle, Prabal Datta, Richard Davey, Peter Langhorne, David J. Stott, Prabal Datta, Timothy J. England, K. Muhidden, Janice O’Connell, Nikhil Majmudar, Joseph Schindler, Wayne M. Clark, Pramodkumar Sethi, Guy Rordorf, Dawn Kleindorfer, Scott Silliman, Mark Gorman, Michael Kelly, Lafayette Singleton, Brett C. Meyer, Christy Jackson, James M. Walker, As’ad Ehtisham, Hewitt C. Goodpasture, David Wang, Pierre Fayad, Steve M Cordina, Dean K. Naritoku, David Chiu, Timothy G. Lukovits, Richard Goddeau, Robin Clark‐Arbogast, Richard N. Leigh, Robert J. Wityk, L. Creed Pettigrew, Ashis Tayal, Judy Jarouse, Gary Friday, Souvik Sen, Anthony Kim, S. Claiborne Johnston, Jacob Elkins, Anna M. Barrett, Enrique C. Leira, Adam G. Kelly, Shelley Burgin, David A. Rempe, Michael Jacoby, Bruce Hughes, Jennifer J. Majersik, Elaine Skalabrin, Jin‐Moo Lee, Chung Hsu, Sophia Sundararajan, Andrew Slivka, Alireza Minagar, Radica Z. Alicic, Madeleine Geraghty, Carlos S. Kase, Maartan Lansberg, Gregory W. Albers, Dennis W. Dietrich, Joseph P. Hanna, Nina T. Gentile, Fernando Santiago, Irene Katzan, Marilou Ching, Sawyer, Tanya Warwick, Engin Y. Yilmaz, Laura Pedelty, Michael Schneck, Bruce M. Coull, Nina J. Solenski, Karen C. Johnston, Vivien Lee, Shyam Prabhakaran, Mark D. Johnson, Isaac E Silverman, Miran Salgado, Robert Birkhahn, Richard H. Strawsburg, Irfan Altafullah, Daniel Aaron Cohen, Richard M. Zweifler, Peterkin Lee Kwen, Maxim D. Hammer, Nirav Vora, Gretchen E. Tietjen, Erfan Albakri, Bhuvaneswari K. Dandapani, Glen C. Jickling, Piero Verro, Matthew J. Roller, Richard L. Hughes, Jennifer S. Simpson, Thomas R. Vidic, Stephanie Lash, Bruce Sigsbee, Daniel G. Rosenbaum, Pasquale Fonzetti, James D. Fleck, Adrian Goldszmidt, Andrei V. Alexandrov, James H. Halsey, Robert A. Hart, Justin A. Sattin, Sandeep Kumar, Diane Book, Michel T. Torbey, James J. Poock, Molly K. King, Glenn D. Graham, Gene Sung, Thomas Mirsen, Alexander W. Dromerick, Andreas D. Runheim, Christy M. Jackson, Eliahu S. Feen, Raymond K. Reichwein, Michael Waters, Colum Amory, Gary L. Bernardini, Rodney Bell, B. Franklin Diamond, Daniel M. Rosenbaum, David Palestrant, Alan Z. Segal, Kathleen Burger, Ronald L. Schwartz, Panayiotis Mitsias, Jeffrey Kramer, Jeffrey Kramer, David C. Robbins, Brian Silver, J. Donald Easton, Edward Feldmann, Marilyn M. Rymer, Joyce Dorssom, Latisha K. Ali, Bruce Ovbiagele, Howard S. Kirshner,
Tópico(s)Neurological Disease Mechanisms and Treatments
ResumoTo assess whether smoking cessation after an ischemic stroke or TIA improves outcomes compared to continued smoking. We conducted a prospective observational cohort study of 3,876 nondiabetic men and women enrolled in the Insulin Resistance Intervention After Stroke (IRIS) trial who were randomized to pioglitazone or placebo within 180 days of a qualifying stroke or TIA and followed up for a median of 4.8 years. A tobacco use history was obtained at baseline and updated during annual interviews. The primary outcome, which was not prespecified in the IRIS protocol, was recurrent stroke, myocardial infarction (MI), or death. Cox regression models were used to assess the differences in stroke, MI, and death after 4.8 years, with correction for adjustment variables prespecified in the IRIS trial: age, sex, stroke (vs TIA) as index event, history of stroke, history of hypertension, history of coronary artery disease, and systolic and diastolic blood pressures. At the time of their index event, 1,072 (28%) patients were current smokers. By the time of randomization, 450 (42%) patients had quit smoking. Among quitters, the 5-year risk of stroke, MI, or death was 15.7% compared to 22.6% for patients who continued to smoke (adjusted hazard ratio 0.66, 95% confidence interval 0.48-0.90). Cessation of cigarette smoking after an ischemic stroke or TIA was associated with significant health benefits over 4.8 years in the IRIS trial cohort.
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