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Lookup NU author(s): Dr Anand Dixit
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© 2017 American Academy of Neurology Objective: To assess whether smoking cessation after an ischemic stroke or TIA improves outcomes compared to continued smoking. Methods: 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. Results: 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). Conclusion: 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.
Author(s): Epstein KA, Viscoli CM, Spence JD, Young LH, Inzucchi SE, Gorman M, Gerstenhaber B, Guarino PD, Dixit A, Furie KL, Kernan WN, For the IRIS Trial Investigators
Publication type: Article
Publication status: Published
Journal: Neurology
Year: 2017
Volume: 89
Issue: 16
Pages: 1723-1729
Print publication date: 17/10/2017
Online publication date: 08/09/2017
Acceptance date: 14/07/2017
ISSN (print): 0028-3878
ISSN (electronic): 1526-632X
Publisher: Lippincott Williams and Wilkins
URL: https://doi.org/10.1212/WNL.0000000000004524
DOI: 10.1212/WNL.0000000000004524
PubMed id: 28887378
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