Frequency of Persistent Smoking Among Patient Undergone Percutaneous Coronary Intervention (PCI) at Tertiary Care Hospital
DOI:
https://doi.org/10.70749/ijbr.v3i7.2816Keywords:
Percutaneous Coronary Intervention, Persistent Smoking, Acute Coronary Syndrome, Cardiovascular Risk Factors, Smoking Cessation.Abstract
Background: Tobacco smoking is a major modifiable risk factor for coronary artery disease and is strongly associated with adverse cardiovascular outcomes. Although percutaneous coronary intervention effectively restores coronary blood flow in patients with acute coronary syndrome, continued smoking after intervention significantly reduces its long-term benefits and increases the risk of recurrent cardiac events. Objective: To determine the frequency of persistent smoking among patients undergone percutaneous coronary intervention (PCI) at a tertiary care cardiac center. Methods: This was a descriptive, cross-sectional study conducted at the Department of Cardiology, Liaquat National Hospital & Medical College, Karachi, from 14 February 2025 to 14 May 2025. A total of 178 patients who had undergone percutaneous coronary intervention (PCI) for acute coronary syndrome were included. Results: Persistent smoking was observed in 68 patients (38.2%), while 110 patients (61.8%) successfully quit smoking after PCI. Higher rates of persistent smoking were noted among younger patients aged 30–44 years (50.0%), males (42.6%), obese individuals (49.2%), and patients with diabetes mellitus (52.2%) and dyslipidemia (47.7%). Heavy smokers consuming more than 20 cigarettes per day showed the highest persistence rate (56.8%). Multivariable analysis identified male gender (adjusted OR 2.14), age <45 years (adjusted OR 2.61), diabetes mellitus (adjusted OR 2.78), dyslipidemia (adjusted OR 1.96), obesity (adjusted OR 1.89), and heavy smoking (adjusted OR 3.12) as independent predictors of persistent smoking. Conclusion: More than one-third of patients continued smoking after PCI, particularly younger males, heavy smokers, and those with metabolic comorbidities. These findings highlight the need for structured, targeted smoking cessation interventions as an integral component of post-PCI care.
Downloads
References
1. Liu, M., He, X., Yang, X., & Wang, Z. (2025). Interpretation of annual report on cardiovascular health and diseases in China 2024. Biomedical and Environmental Sciences, 38(8), 893-917.
https://doi.org/10.3967/bes2025.099
2. Cardiovascular diseases (CVDs). World Health Organization. 2025.
https://www.who.int/news-room/fact-sheets/detail/cardiovascular-diseases-(cvds)
3. China Health Statistics Yearbook 2021. 2021.
http://www.tjnjw.com/hangyefb/w/zhongguo-weishengjiankang-tongjinianjian-2022.html
4. Myers, J., Prakash, M., Froelicher, V., Do, D., Partington, S., & Atwood, J. E. (2002). Exercise capacity and mortality among men referred for exercise testing. New England Journal of Medicine, 346(11), 793-801.
https://doi.org/10.1056/nejmoa011858
5. Piepoli, M. F., Hoes, A. W., Agewall, S., Albus, C., Brotons, C., Catapano, A. L., Cooney, M., Corrà, U., Cosyns, B., Deaton, C., Graham, I., Hall, M. S., Hobbs, F. D., Løchen, M., Löllgen, H., Marques-Vidal, P., Perk, J., Prescott, E., Redon, J., … Verschuren, W. M. (2016). 2016 European guidelines on cardiovascular disease prevention in clinical practice. European Heart Journal, 37(29), 2315-2381.
https://doi.org/10.1093/eurheartj/ehw106
6. Howarter, A. D., Bennett, K. K., Barber, C. E., Gessner, S. N., & Clark, J. M. (2014). Exercise self-efficacy and symptoms of depression after cardiac rehabilitation. Journal of Cardiovascular Nursing, 29(2), 168-177.
https://doi.org/10.1097/jcn.0b013e318282c8d6
7. Fletcher, G. F., Ades, P. A., Kligfield, P., Arena, R., Balady, G. J., Bittner, V. A., ... & Williams, M. A. (2013). Exercise standards for testing and training: a scientific statement from the American Heart Association. Circulation, 128(8), 873-934.
https://doi.org/10.1161/CIR.0b013e31829b5b44
8. Dibben, G. O., Faulkner, J., Oldridge, N., Rees, K., Thompson, D. R., Zwisler, A., & Taylor, R. S. (2023). Exercise-based cardiac rehabilitation for coronary heart disease: A meta-analysis. European Heart Journal, 44(6), 452-469.
https://doi.org/10.1093/eurheartj/ehac747
9. Gomes-Neto, M., Durães, A. R., Conceição, L. S., Saquetto, M. B., Alves, I. G., Smart, N. A., & Carvalho, V. O. (2024). Some types of exercise interventions are more effective than others in people with coronary heart disease: Systematic review and network meta-analysis. Journal of Physiotherapy, 70(2), 106-114.
https://doi.org/10.1016/j.jphys.2024.02.018
10. Kotseva, K., Rydén, L., De Backer, G., De Bacquer, D., & Wood, D. (2015). EURObservational research programme: EUROASPIRE: the Euroaspire survey of cardiovascular prevention and diabetes in 24 countries in Europe. European heart journal, 36(16), 950-951.
https://biblio.ugent.be/publication/5947919
11. Wongvibulsin, S., Habeos, E. E., Huynh, P. P., Xun, H., Shan, R., Porosnicu Rodriguez, K. A., Wang, J., Gandapur, Y. K., Osuji, N., Shah, L. M., Spaulding, E. M., Hung, G., Knowles, K., Yang, W. E., Marvel, F. A., Levin, E., Maron, D. J., Gordon, N. F., & Martin, S. S. (2021). Digital health interventions for cardiac rehabilitation: Systematic literature review. Journal of Medical Internet Research, 23(2), e18773.
12. Thakker, R., Khan, M., & Al-Hemyari, B. (2023). Cardiac rehabilitation after hospitalization for acute coronary syndrome. Current Cardiology Reports, 25(12), 1699-1703.
https://doi.org/10.1007/s11886-023-02010-5
13. Masterson Creber, R., Dodson, J. A., Bidwell, J., Breathett, K., Lyles, C., Harmon Still, C., Ooi, S., Yancy, C., & Kitsiou, S. (2023). Telehealth and health equity in older adults with heart failure: A scientific statement from the American Heart Association. Circulation: Cardiovascular Quality and Outcomes, 16(11).
https://doi.org/10.1161/hcq.0000000000000123
14. Duff, O. M., Walsh, D. M., Furlong, B. A., O'Connor, N. E., Moran, K. A., & Woods, C. B. (2017). Behavior change techniques in physical activity eHealth interventions for people with cardiovascular disease: Systematic review. Journal of Medical Internet Research, 19(8), e281.
https://doi.org/10.2196/jmir.7782
15. Johnston, M., Carey, R. N., Connell Bohlen, L., Johnston, D. W., Rothman, A., De Bruin, M., Kelly, M. P., Groarke, H., & Michie, S. (2018). Development of an online tool for linking behavior change techniques and mechanisms of action based on triangulation of findings from literature synthesis and expert consensus.
https://doi.org/10.31234/osf.io/ur6kz
16. Agyei, E. E., Ekpezu, A., & Oinas-Kukkonen, H. (2024). Persuasive systems design trends in coronary heart disease management: Scoping review of randomized controlled trials. JMIR Cardio, 8, e49515.
17. Chatterjee, S., & Price, A. (2009). Healthy living with persuasive technologies: Framework, issues, and challenges. Journal of the American Medical Informatics Association, 16(2), 171-178.
https://doi.org/10.1197/jamia.m2859
18. Oyibo, K., & Morita, P. P. (2021). Designing better exposure notification apps: The role of persuasive design. JMIR Public Health and Surveillance, 7(11), e28956.
19. Hayes Watson, C., Nuss, H., Celestin, M., Tseng, T. S., Parada, N., Yu, Q., & Moody-Thomas, S. (2018). Health beliefs associated with poor disease self-management in smokers with asthma and/or COPD: A pilot study. Journal of Asthma, 56(9), 1008-1015.
https://doi.org/10.1080/02770903.2018.1509990
20. Authors/Task Force Members:, McDonagh, T. A., Metra, M., Adamo, M., Gardner, R. S., Baumbach, A., ... & ESC Scientific Document Group. (2022). 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: Developed by the Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). With the special contribution of the Heart Failure Association (HFA) of the ESC. European journal of heart failure, 24(1), 4-131.
https://doi.org/10.1002/ejhf.2333
21. Alhasani, M., Mulchandani, D., Oyebode, O., Baghaei, N., & Orji, R. (2022). A systematic and comparative review of behavior change strategies in stress management apps: Opportunities for improvement. Frontiers in Public Health, 10.
https://doi.org/10.3389/fpubh.2022.777567
22. Kortum, P., Acemyan, C. Z., & Oswald, F. L. (2020). Is it time to go positive? Assessing the positively worded system usability scale (SUS). Human Factors: The Journal of the Human Factors and Ergonomics Society, 63(6), 987-998.
https://doi.org/10.1177/0018720819881556
23. Widmer, R. J., Senecal, C., Allison, T. G., Lopez-Jimenez, F., Lerman, L. O., & Lerman, A. (2020). Dose-response effect of a digital health intervention during cardiac rehabilitation: Subanalysis of randomized controlled trial. Journal of Medical Internet Research, 22(2), e13055.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Indus Journal of Bioscience Research
This work is licensed under a Creative Commons Attribution 4.0 International License.
