Ischemic Stroke

Smoking Cessation After Stroke, TIA Improves 5-Year Outcomes

Smoking cessation following an ischemic stroke or transient ischemic attack (TIA) is associated with an improved 5-year risk of recurrent stroke, myocardial infarction (MI), or mortality, according to a recent study.

For their study, the researchers assessed 3876 men and women without diabetes who had been enrolled in the Insulin Resistance Intervention After Stroke (IRIS) trial. Participants were randomly assigned to receive either pioglitazone or placebo within 180 days of a stroke or TIA. Median follow-up lasted 4.8 years. Patients’ history of tobacco use was obtained at baseline and was updated in annual interviews.
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The primary outcome was recurrent stroke, MI, or death. Differences in the rates of stroke, MI, and death after 4.8 years were examined via Cox regression models. Results were adjusted for variables that had been prespecified in the IRIS trial: age, sex, stroke compared with TIA as the index event, history of stroke, history of hypertension, history of coronary artery disease, and systolic and diastolic blood pressures.

A total of 1072 (28%) patients had been current smokers at the time of their index event. However, 450 (42%) patients had quit smoking prior to randomization. Results indicated that the 5-year risk of stroke, MI, or death was 15.7% among those who quit smoking vs 22.6% among those who continued smoking.

“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,” the researchers concluded.

—Christina Vogt

Reference:

Epstein KA, Viscoli CM, Spence JD, et al. Smoking cessation and outcome after ischemic stroke or TIA [Published online September 8, 2017]. Neurology. http:/​/​dx.​doi.​org/​10.​1212/​WNL.​0000000000004524.