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Randomized Controlled Trial
. 2017 Apr 18;6(4):e004785.
doi: 10.1161/JAHA.116.004785.

Smokers and Postcessation Weight Gain After Acute Coronary Syndrome

Payam Dehghani  1 , Bettina Habib  2 , Sarah B Windle  2 , Nathalie Roy  3 , Wayne Old  4 , François R Grondin  5 , Iqbal Bata  6 , Ayman Iskander  7 , Claude Lauzon  8 , Nalin Srivastava  9 , Adam Clarke  10 , Daniel Cassavar  11 , Danielle Dion  12 , Herbert Haught  13 , Shamir R Mehta  14 , Jean-François Baril  15 , Charles Lambert  16 , Mina Madan  17 , Beth L Abramson  18 , Mark J Eisenberg  19   20   21
Affiliations
Randomized Controlled Trial

Smokers and Postcessation Weight Gain After Acute Coronary Syndrome

Payam Dehghani et al. J Am Heart Assoc. .

Abstract

Background: Smoking cessation and weight management are recommended after acute coronary syndrome (ACS); however, little is known about the effects of smoking cessation on weight change after ACS. We aimed to assess the effect of smoking cessation after ACS on weight over a 12-month follow-up period.

Methods and results: Data were prospectively collected from the EVITA (Evaluation of Varenicline in Smoking Cessation for Patients Post-Acute Coronary Syndrome) trial. Weight change was compared among 3 groups of patients: those who were completely abstinent (n=70), those who smoked intermittently (n=68), and those who smoked persistently (n=34). Patients' mean baseline weight was 83.9 kg (SD 17.7) with a mean body mass index of 28.5 (SD 5.4). Patients smoked a mean of 37.7 years (SD 17.7) and a mean of 21.0 cigarettes (SD 9.0) per day prior to their ACS. Weight change varied across groups, with abstainers gaining a mean of 4.8 kg (SD 8.6), intermittent smokers gaining a mean of 2.0 kg (SD 8.9) and persistent smokers losing a mean of 0.7 kg (SD 7.4). At 52 weeks, abstainers were more likely to gain weight than persistent smokers (difference in means 5.5 kg; 95% CI 2.3-8.8). This weight gain was not associated with an increase in the use of antihypertensive or antidiabetic medications.

Conclusions: Following an ACS, significant weight is gained by patients who quit smoking. Weight-management interventions among smokers who quit after ACS should be a focus of investigation in future research so that the cardiovascular benefits achieved by smoking cessation are not offset by weight gain in this high-risk population.

Clinical trial registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00794573.

Keywords: acute coronary syndrome; secondary prevention; smoking; weight gain.

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Figures

Figure 1
Figure 1
Proportion of patients with >5% body weight gain or loss according to pattern of smoking at 52 weeks. Compared with persistent smokers, many more abstainers gained >5% of their body weight over 12 months of follow‐up.
Figure 2
Figure 2
Weight changes within and between different categories of smokers. A significant difference in change of weight from baseline to 52 weeks was observed between smokers who became abstainers and smokers who continued to smoke persistently.
Figure 3
Figure 3
Changes in BMI according to pattern of smoking at week 52. The most notable change in BMI over the course of follow‐up was observed in the abstainers. The patients classified as obese (BMI ≥30.0) changed from 33% to 51%. BMI indicates body mass index.
Figure 4
Figure 4
Changes in blood pressure according to percentage body weight gain. The entire cohort's blood pressure increased over the course of follow‐up with a numerically higher increase in systolic blood pressure in patients who gained >5%.
See this image and copyright information in PMC

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