Smokers and Postcessation Weight Gain After Acute Coronary Syndrome

Background: smoking cessation and weight management are recommended after acute coronary syndrome (acs); however,little is known about the effects of smoking cessation on weight change after acs. we aimed to assess the effect of smoking cessation after acs on weight over a 12-month follow-up period.methods and results: 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 (sd 17.7) with a mean body mass index of 28.5 (sd 5.4). patients smoked a mean of 37.7 years (sd 17.7) and a mean of 21.0 cigarettes (sd 9.0) per day prior to their acs. weight change varied across groups,with abstainers gaining a mean of 4.8 kg (sd 8.6),intermittent smokers gaining a mean of 2.0 kg (sd 8.9) and persistent smokers losing a mean of 0.7 kg (sd 7.4). at 52 weeks,abstainers were more likely to gain weight than persistent smokers (difference in means 5.5 kg; 95% ci 2.3-8.8). this weight gain was not associated with an increase in the use of antihypertensive or antidiabetic medications.conclusions: following an acs,significant weight is gained by patients who quit smoking. weight-management interventions among smokers who quit after acs 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.clinical trial registration: url: http://www.clinicaltrials.gov. unique identifier: nct00794573. © 2017 the authors. published on behalf of the american heart association,inc.,by wiley.