CME: Smoking Cessation After PCI
It has been well-documented in clinical studies that smoking cessation after patients undergo PCI can improve outcomes. Some research has identified certain predictors of smoking cessation after PCI, including beginning vaporizer, previous cigarette consumption and the number of coexisting coronary artery disease risk factors. Few studies, however, have assessed current trends in smoking cessation after PCI and looked at the potential impact of smoke-free policies that are being enacted throughout many parts of the United States. “Historically, patients who undergo PCI are a group that has more difficulty quitting smoking than others,” says Randal J. Thomas, MD, MS. The Effect of Smoke-Free Policies In a study published in the February 15, 2015 issue of the American Journal of Cardiology, Dr. Thomas and colleagues assessed trends and predictors of smoking cessation after PCI in Olmsted County, Minnesota. The investigators conducted the research at a time when local and statewide smoke-free public policies were enacted in Olmsted County. The study followed 2,306 patients who underwent their first PCI from 1999 to 2009 for 12 months. The researchers conducted structured telephone surveys at 6 and 12 months after PCI to assess smoking status and quit rates during the 10-year period. The authors paid particular attention to quite rates around two dates when three smoke-free ordinances were implemented to reduce secondhand tobacco exposure in Olmsted County. The first date was January 1, 2002, when an ordinance was passed requiring restaurants to be smoke-free. The second was October 1, 2007, when ordinances required both workplaces and the entire state of Minnesota to be smoke-free. The data were then analyzed according to three time periods: 1991 to...
Smoking Cessation After PCI
It has been well-documented in clinical studies that smoking cessation after patients undergo PCI can improve outcomes. Some research has identified certain predictors of smoking cessation after PCI, including previous cigarette consumption and the number of coexisting coronary artery disease risk factors. Few studies, however, have assessed current trends in smoking cessation after PCI and looked at the potential impact of smoke-free policies that are being enacted throughout many parts of the United States. “Historically, patients who undergo PCI are a group that has more difficulty quitting smoking than others,” says Randal J. Thomas, MD, MS. The Effect of Smoke-Free Policies In a study published in the February 15, 2015 issue of the American Journal of Cardiology, Dr. Thomas and colleagues assessed trends and predictors of smoking cessation after PCI in Olmsted County, Minnesota. The investigators conducted the research at a time when local and statewide smoke-free public policies were enacted in Olmsted County. The study followed 2,306 patients who underwent their first PCI from 1999 to 2009 for 12 months. The researchers conducted structured telephone surveys at 6 and 12 months after PCI to assess smoking status and quit rates during the 10-year period. The authors paid particular attention to quite rates around two dates when three smoke-free ordinances were implemented to reduce secondhand tobacco exposure in Olmsted County. The first date was January 1, 2002, when an ordinance was passed requiring restaurants to be smoke-free. The second was October 1, 2007, when ordinances required both workplaces and the entire state of Minnesota to be smoke-free. The data were then analyzed according to three time periods: 1991 to 2001, 2002...
Guidance for PCI Without On-Site Surgical Backup
In 2007, the Society for Cardiovascular Angiography and Interventions (SCAI) published an expert consensus document on the current status and future direction of PCI without on-site surgical backup. The document reviewed the existing literature and examined recommendations for performing PCI in this setting from several existing programs and other sources, thereby defining best practices for facilities and operators. “Since that time, new studies, meta-analyses, and randomized trials have been published in which PCI with and without on-site surgery has been compared,” says Gregory J. Dehmer, MD, FACC, FACP, FSCAI. “In addition, professional organizations have published appropriate use criteria for coronary revascularization and other documents affecting the practice of PCI.” According to Dr. Dehmer, several noteworthy changes occurred in PCI guidelines that were released in 2011. “Elective PCI was upgraded to Class IIb, and primary PCI was upgraded to Class IIa at facilities without on-site surgery,” he says. In addition to the PCI guidelines, expert consensus documents and competency documents related to PCI plus additional research have provided more information on ways to optimize the structure and operation of PCI programs without on-site surgery. Consolidating Recommendations In 2014, SCAI—in collaboration with the American College of Cardiology and the American Heart Association—released a new expert consensus document on PCI at sites without on-site surgical backup. This document consolidates the myriad of recommendations that have been released in different forms since the 2007 document. “The recommendations are designed to improve safety while maintaining access to quality care,” says Dr. Dehmer, who was lead author of both the 2007 and 2014 consensus documents. As cited in the new document, 11 original studies and...