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Article

Smoking Cessation after Diagnosis of New-Onset Atrial Fibrillation and the Risk of Stroke and Death

1
Department of Internal Medicine, Seoul National University Hospital, Seoul 03080, Korea
2
Department of Internal Medicine, Seoul National University College of Medicine, Seoul 03080, Korea
3
Department of Medical Statistics, College of Medicine, Catholic University of Korea, Seoul 06591, Korea
4
Statistics and Actuarial Science, Soongsil University, Seoul 06978, Korea
5
Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Chest & Heart Hospital, Liverpool L14 3PE, UK
6
Department of Clinical Medicine, Aalborg University, 9000 Aalborg, Denmark
*
Author to whom correspondence should be addressed.
Academic Editor: Roberto De Ponti
J. Clin. Med. 2021, 10(11), 2238; https://doi.org/10.3390/jcm10112238
Received: 19 April 2021 / Revised: 17 May 2021 / Accepted: 18 May 2021 / Published: 21 May 2021
(This article belongs to the Section Cardiology)
Limited data are available regarding the impact of smoking cessation after atrial fibrillation (AF) diagnosis on clinical outcomes. Using the Korean National Health Insurance Service database, we included patients newly diagnosed with AF and categorized them into four groups as follows: (i) never smokers, (ii) ex-smokers, (iii) smoking cessation after AF diagnosis (“quitters”), and (iv) current smokers. The primary outcomes were incident ischemic stroke and all-cause death during follow-up. Fatal ischemic stroke and death from cerebrovascular events were evaluated as secondary outcomes. Among 97,637 patients (mean age, 61 years; mean CHA2DS2-VASc score, 2.3), 6.9% stopped smoking after AF diagnosis. The mean follow-up duration was 3.2 ± 2.0 years. After multivariable adjustment, quitters had lower risks of ischemic stroke (hazard ratio (HR), 0.702; 95% confidence interval (CI), 0.595–0.827) and all-cause death (HR, 0.842; 95% CI, 0.748–0.948) than current smokers. Quitters after AF diagnosis were associated with lower risks of fatal ischemic stroke (HR, 0.454; 95% CI, 0.287–0.718) and death from cerebrovascular events (HR, 0.664; 95% CI, 0.465–0.949) compared with current smokers. Quitting smoking may reduce the risk of ischemic stroke, the severity of ischemic stroke, and the incidence of cerebrovascular events in patients with new-onset AF. View Full-Text
Keywords: smoking; atrial fibrillation; stroke; death smoking; atrial fibrillation; stroke; death
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MDPI and ACS Style

Lee, S.-R.; Choi, E.-K.; Jung, J.-H.; Han, K.-D.; Oh, S.; Lip, G.Y.H. Smoking Cessation after Diagnosis of New-Onset Atrial Fibrillation and the Risk of Stroke and Death. J. Clin. Med. 2021, 10, 2238. https://doi.org/10.3390/jcm10112238

AMA Style

Lee S-R, Choi E-K, Jung J-H, Han K-D, Oh S, Lip GYH. Smoking Cessation after Diagnosis of New-Onset Atrial Fibrillation and the Risk of Stroke and Death. Journal of Clinical Medicine. 2021; 10(11):2238. https://doi.org/10.3390/jcm10112238

Chicago/Turabian Style

Lee, So-Ryoung, Eue-Keun Choi, Jin-Hyung Jung, Kyung-Do Han, Seil Oh, and Gregory Y.H. Lip 2021. "Smoking Cessation after Diagnosis of New-Onset Atrial Fibrillation and the Risk of Stroke and Death" Journal of Clinical Medicine 10, no. 11: 2238. https://doi.org/10.3390/jcm10112238

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