1. Impact of the radial versus femoral access for primary percutaneous intervention on smoking cessation rates: A paradoxus between the health related quality of life and smoking quitting?
- Author
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Cengiz Burak, Burak Açar, Murat Gul, Serkan Cay, Ozcan Ozeke, Erdogan Ilkay, Dursun Aras, Serkan Topaloglu, E. Hande Ozcan Cetin, Bulent Deveci, [Deveci, Bulent] Canakkale Onsekiz Mart Univ, Dept Cardiol, Canakkale, Turkey -- [Ozeke, Ozcan -- Acar, Burak -- Cetin, Elif Hande Ozcan -- Burak, Cengiz -- Cay, Serkan -- Topaloglu, Serkan -- Aras, Dursun -- Ilkay, Erdogan] Hlth Sci Univ, Turkiye Yuksek Ihtisas Training & Res Hosp, Dept Cardiol, Ankara, Turkey -- [Gul, Murat] Aksaray Univ, Turkiye Yuksek Ihtisas Training & Res Hosp, Dept Cardiol, Aksaray, Turkey, Ozeke, Ozcan -- 0000-0002-4770-8159, Gul, Murat -- 0000-0001-6841-1998, Tıp Fakültesi, and Özeke, Özcan -- 0000-0002-4770-8159
- Subjects
Gynecology ,Health related quality of life ,medicine.medical_specialty ,Radial approach ,business.industry ,Primary percutaneous coronary intervention ,Quitting ,Smoking cessation ,030204 cardiovascular system & hematology ,Femoral approach ,STEMI ,03 medical and health sciences ,0302 clinical medicine ,Femoral access ,medicine ,030212 general & internal medicine ,Cardiology and Cardiovascular Medicine ,business - Abstract
WOS: 000442902500007, Background: Smoking cessation is potentially the most effective secondary prevention measure and improves prognosis after acute ST-segment elevation myocardial infarction (STEMI), but more than half of the patients continue to smoke after STEMI. The awareness of the disease's severity and the short hospital stay at the index STEMI have been found to be associated with persistent smoking after STEMI. Objective: To assess whether the paradoxical relationship between smoking quitting rates and health-related quality of life (QOL) scores in STEMI patients undergoing primary percutaneous intervention (pPCI) by radial (RA) versus femoral approach (FA). Methods: Our population is represented by 138 STEMI patients undergoing pPCI by FA or RA. The smoking cessation rates and QOL scores were evaluated. Results: Patients at RA group (46 patients, 57 +/- 9 years, 87% male) had a higher European Quality of Life-5 Dimensions (EQ-5D) index score at post-PCI first week compared to FA group (92 patients, 57 +/- 8 years, 75% male) [FA: median 0.81 (0.22) vs. RA: 1 (0.22), p = 0.042], although it was similar at baseline [FA: median 1 (0) vs. RA: 1 (0), p = 0.992]. Total hospital length of stay [RA: median 3 (1) day vs. FA: 4 (1), p < 0.001] was significantly reduced in the RA group. Whereas the smoking cessation rates at 1-year post-discharge were 41% in RA group, it was 67% in FA group (p = 0.003). Female sex, pain-to-door time and RA during p-PCI were independent predictors of continued smoking after STEMI. Conclusion: This study shows that the smoking cessation was lower in RA group compared to FA group. The more comfortable conditions of STEMI management related to RA may cause a lower awareness of the disease severity and lower motivation to quit smoking. Therefore, it is important to inquire about smoking status at each clinical encounter, particularly in patients undergoing pPCI by the radial approach. (c) 2018 The Czech Society of Cardiology. Published by Elsevier Sp. z o.o. All rights reserved.
- Published
- 2018