Persistent smoking can cause stroke recurrence: JAHA Study

CHINA: Persistent smoking is linked to increased risk of stroke recurrence in a recent study published in the Journal of the American Heart Association. According to the study, a strong dose-response relationship exists between smoking quantity and the risk of stroke recurrence.

Smoking is a well‐established risk factor of stroke. Smoking cessation has been recommended for stroke prevention. However, to date, there are no studies on the impact of smoking status on stroke recurrence. Jingjing Chen, Department of Neurology, Jinling Hospital, Nanjing Medical University, Jiangsu, China, and colleagues conducted the study to determine how stroke recurrence is affected by smoking status.

For the purpose, they analyzed and followed patients with first-ever stroke enrolled in the NSRP (Nanjing Stroke Registry Program). Smoking status was assessed at baseline and reassessed at the first follow‐up. The primary end point was defined as fatal or nonfatal recurrent stroke after 3 months of the index stroke.

At baseline, among 3069 patients included, 1331 (43.4%) were nonsmokers, 263 (8.6%) were former smokers, and 1475 (48.0%) were current smokers.

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Key findings of the study include:

• At the first follow‐up, 908 (61.6%) patients quit smoking. After a mean follow‐up of 2.4±1.2 years, 293 (9.5%) patients had stroke recurrence.


• With nonsmokers as the reference, the adjusted hazard ratios for stroke recurrence were 1.16 (95% CI, 0.75–1.79) in former smokers, 1.31 in quitters, and 1.93 in persistent smokers.


• Among persistent smokers, hazard ratios for stroke recurrence ranged from 1.68 (95% CI, 1.14–2.48) in those who smoked 1 to 20 cigarettes daily to 2.72 (95% CI, 1.36–5.43) in those who smoked more than 40 cigarettes daily (P for trend <0.001).

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"After an initial stroke, persistent smoking increases the risk of stroke recurrence. There exists a strong dose–response relationship between smoking quantity and the risk of stroke recurrence. These results highlight the importance of smoking cessation for secondary stroke prevention," concluded the authors.

For detailed research follow the link: https://doi.org/10.1161/JAHA.118.011696