Assessment of smoking care by stroke specialists in patients with recent TIA and minor stroke: an international prospective registry-based cohort study
Objectives The objectives are to assess smoking abstinence and its effects on vascular risk and to report tobacco-cessation counselling and pharmacotherapy use in patients who had a recent minor stroke or transient ischaemic attack (TIA). - Design and setting The TIA registry.org project is a prospe...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article (Journal) |
| Language: | English |
| Published: |
July 03, 2024
|
| In: |
BMJ open
Year: 2024, Volume: 14, Issue: 7, Pages: 1-9 |
| ISSN: | 2044-6055 |
| DOI: | 10.1136/bmjopen-2023-078632 |
| Online Access: | Verlag, kostenfrei, Volltext: https://doi.org/10.1136/bmjopen-2023-078632 Verlag, kostenfrei, Volltext: https://bmjopen.bmj.com/content/14/7/e078632 
|
| Author Notes: | Philippa Lavallee, Hugo Charles, Julien Labreuche, Gregory W. Albers, Louis Caplan, Geoffrey A. Donnan, José Manuel Ferro, M.G. Hennerici, Carlos A. Molina, Peter Rothwell, Gabriel Steg, Pierre-Jean Touboul, Shinichiro Uchiyama, Eric Vicaut, Lawrence K.S. Wong, Pierre Amarenco |
| Summary: | Objectives The objectives are to assess smoking abstinence and its effects on vascular risk and to report tobacco-cessation counselling and pharmacotherapy use in patients who had a recent minor stroke or transient ischaemic attack (TIA). - Design and setting The TIA registry.org project is a prospective, observational registry of patients with TIA and minor stroke that occurred in the previous 7 days with a 5-year follow-up, involving 61 sites with stroke specialists in 21 countries (Europe, Asia, Latin America and Middle East). Of those, 42 sites had 5-year follow-up data on more than 50% of their patients and were included in the present study. - Participants From June 2009 through December 2011, 3847 patients were eligible for the study (80% of the initial cohort). - Outcomes Tobacco counselling and smoking-cessation pharmacotherapy use in smoking patients were reported at discharge. Association between 3-month smoking status and risk of a major cardiovascular event (MACE) was analysed with multivariable Cox regression model. - Results Among 3801 patients included, 835 (22%) were smokers. At discharge, only 35.2% have been advised to quit and 12.5% had smoking-cessation pharmacotherapy prescription. At 3 months, 383/835 (46.9%) baseline smokers were continuers. Living alone and alcohol abuse were associated with persistent smoking; high level of education, aphasia and dyslipidaemia with quitting. The adjusted HRs for MACE at 5 years were 1.13 (95% CI 0.90 to 1.43) in former smokers, 1.31 (95% CI 0.93 to 1.84) in quitters and 1.31 (95% CI 0.94 to 1.83) in continuers. Using time-varying analysis, current smoking at the time of MACE non-significantly increased the risk of MACE (HR 1.31 (95% CI 0.97 to 1.78); p=0.080). - Conclusion In the TIAregistry.org, smoking-cessation intervention was used in a minority of patients. Surprisingly, in this population in which, at 5 years, other vascular risk factors were well controlled and antithrombotic treatment maintained, smoking cessation non-significantly decreased the risk of MACE. |
|---|---|
| Item Description: | Gesehen am 29.09.2025 |
| Physical Description: | Online Resource |
| ISSN: | 2044-6055 |
| DOI: | 10.1136/bmjopen-2023-078632 |