Association of smoking with restenosis and major adverse cardiac events after coronary stenting: A meta-analysis

Background and objective: the association between smoking and clinical outcomes after coronary stenting is controversial. the aim of this meta-analysis was to assess the association between smoking and in stent restenosis (isr), major adverse cardiac events (mace), or major adverse cardiac and cerebrovascular events (macce) after coronary stenting. methods: a search for studies published before december 2014 was conducted in pubmed, embase, and cochrane library. an inverse random weighted meta-analysis was conducted using logarithm of the odds ratio (or) and its standard error for each study. results: ten studies investigated the association between smoking and isr. overall, smoking was not associated with isr (or: 1.05, 95% ci: 0.79–1.41; i2 = 47.8%). subgroup analysis also failed to show a significant association between smoking and isr risk regardless of bare metal stent (bms) and drug-eluting stent (des) implantation. eight studies explored the association between smoking and mace, but no association was found (or: 0.92, 95% ci: 0.77–1.10; i2 = 25.5%), and subgroup analysis revealed that no distinct difference was found between bms and des implantation. three studies investigated the association between smoking and macce and significant association was found (or: 2.09, 95% ci: 1.43–3.06; i2 = 21.6%). conclusions: our results suggest that in patients undergoing percutaneous coronary intervention with stent implantation, smoking is not associated with isr and mace; however, smoking is an independent risk factor for macce.