Smokers and Postcessation Weight Gain After Acute Coronary Syndrome

<jats:sec xml:lang="en"> <jats:title>Background</jats:title> <jats:p xml:lang="en"> Smoking cessation and weight management are recommended after acute coronary syndrome ( <jats:styled-content style="fixed-case">ACS</jats:styled-content> ); however, little is known about the effects of smoking cessation on weight change after <jats:styled-content style="fixed-case">ACS</jats:styled-content> . We aimed to assess the effect of smoking cessation after <jats:styled-content style="fixed-case">ACS</jats:styled-content> on weight over a 12‐month follow‐up period. </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Methods and Results</jats:title> <jats:p xml:lang="en"> Data were prospectively collected from the EVITA (Evaluation of Varenicline in Smoking Cessation for Patients Post‐Acute Coronary Syndrome) trial. Weight change was compared among 3 groups of patients: those who were completely abstinent (n=70), those who smoked intermittently (n=68), and those who smoked persistently (n=34). Patients' mean baseline weight was 83.9 kg ( <jats:styled-content style="fixed-case">SD</jats:styled-content> 17.7) with a mean body mass index of 28.5 ( <jats:styled-content style="fixed-case">SD</jats:styled-content> 5.4). Patients smoked a mean of 37.7 years ( <jats:styled-content style="fixed-case">SD</jats:styled-content> 17.7) and a mean of 21.0 cigarettes ( <jats:styled-content style="fixed-case">SD</jats:styled-content> 9.0) per day prior to their <jats:styled-content style="fixed-case">ACS</jats:styled-content> . Weight change varied across groups, with abstainers gaining a mean of 4.8 kg ( <jats:styled-content style="fixed-case">SD</jats:styled-content> 8.6), intermittent smokers gaining a mean of 2.0 kg ( <jats:styled-content style="fixed-case">SD</jats:styled-content> 8.9) and persistent smokers losing a mean of 0.7 kg ( <jats:styled-content style="fixed-case">SD</jats:styled-content> 7.4). At 52 weeks, abstainers were more likely to gain weight than persistent smokers (difference in means 5.5 kg; 95% <jats:styled-content style="fixed-case">CI</jats:styled-content> 2.3–8.8). This weight gain was not associated with an increase in the use of antihypertensive or antidiabetic medications. </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Conclusions</jats:title> <jats:p xml:lang="en"> Following an <jats:styled-content style="fixed-case">ACS</jats:styled-content> , significant weight is gained by patients who quit smoking. Weight‐management interventions among smokers who quit after <jats:styled-content style="fixed-case">ACS</jats:styled-content> should be a focus of investigation in future research so that the cardiovascular benefits achieved by smoking cessation are not offset by weight gain in this high‐risk population. </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Clinical Trial Registration</jats:title> <jats:p xml:lang="en"> <jats:styled-content style="fixed-case">URL</jats:styled-content> : <jats:ext-link xmlns:xlink="http://www.w3.org/1999/xlink" ext-link-type="uri" xlink:href="http://www.clinicaltrials.gov">http://www.clinicaltrials.gov</jats:ext-link> . Unique identifier: <jats:styled-content style="fixed-case">NCT</jats:styled-content> 00794573. </jats:p> </jats:sec>