Clinical characteristics of patients with coronary artery disease by smoking status

BACKGROUND: Many people worldwide use different tobacco products. Currently, most studies of smoking in various populations are focused on determining relationships, including the number of cigarettes smoked per day, pack/year and smoking indexes. Some studies evaluate important characteristics, such as the degree of nicotine dependence, type of smoking behavior, and level of motivation to quit smoking. This fact highlights this study relevance of a comprehensive assessment of smoking status.

AIM: To evaluate the prevalence of smoking types and analyze the features of clinical and medical history characteristics of smoking patients with stable coronary artery disease (CAD).

MATERIALS AND METHODS: Data of 381 patients with CAD hospitalized for routine myocardial revascularization were analyzed. Out of examined patients, 107 were considered active smokers. To determine the smoking status, the level of motivation to quit smoking, degree of nicotine dependence, and type of smoking behavior were evaluated using the K. Fagerstrom test, J. Prochaska questionnaire, and D. Horn questionnaire, respectively. Clinical and medical history characteristics were also analyzed.

RESULTS: More than half of patients with CAD had mild [34 (31.8%)] or moderate [33 (30.8%)] nicotine dependence, and a quarter of patients had high [25 (23.4%)] or very high [15 (14%)] dependence. Also, more than half of smoking patients [60 (56.1%)] were not motivated to quit smoking, 41 (38.3%) were poorly motivated, and only 6 (5.6%) were highly motivated. Among smoking patients with CAD, 32 (29.9%), 40 (37.4%), and 1/3 of patients [5 (32.7%)] had psychological (stimulation type), physical (thirst type), and support type of dependence, respectively. Based on clinical and medical history characteristics, more severe comorbidity was common in patients with high and very high nicotine dependence, high motivation to quit smoking, and thirst type of smoking behavior. Percutaneous coronary interventions, history of acute cardiovascular events, arterial hypertension, multifocal atherosclerosis, and multivessel disease as defined by SYNTAX were more common in this group of patients.

CONCLUSION: Smokers with CAD hospitalized for routine myocardial revascularization had mainly a mild or moderate degree of nicotine dependence, more than half of patients was not motivated to quit smoking and had thirst and support types of smoking behavior. The severe smoking cohort included patients with high and very high degree of nicotine dependence, high motivation to quit smoking, and thirst type of smoking behavior.