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...

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Hauptverfasser: Lavallée, Philippa (VerfasserIn) , Charles, Hugo (VerfasserIn) , Labreuche, Julien (VerfasserIn) , Albers, Gregory W. (VerfasserIn) , Caplan, Louis (VerfasserIn) , Donnan, Geoffrey A. (VerfasserIn) , Ferro, José Manuel (VerfasserIn) , Hennerici, Michael G. (VerfasserIn) , Molina, Carlos A. (VerfasserIn) , Rothwell, Peter (VerfasserIn) , Steg, Gabriel (VerfasserIn) , Touboul, Pierre-Jean (VerfasserIn) , Uchiyama, Shinichiro (VerfasserIn) , Vicaut, Eric (VerfasserIn) , Wong, Lawrence K. S. (VerfasserIn) , Amarenco, Pierre (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: July 03, 2024
In: BMJ open
Year: 2024, Jahrgang: 14, Heft: 7, Pages: 1-9
ISSN:2044-6055
DOI:10.1136/bmjopen-2023-078632
Online-Zugang:Verlag, kostenfrei, Volltext: https://doi.org/10.1136/bmjopen-2023-078632
Verlag, kostenfrei, Volltext: https://bmjopen.bmj.com/content/14/7/e078632
Volltext
Verfasserangaben: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

MARC

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520 |a 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. 
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