The impact of smoking on mortality risk in angiographied coronary patients is unclear and is addressed in the present study. We enrolled 1804 consecutive patients undergoing coronary angiography for the evaluation of established or suspected stable coronary disease (CAD). Patients who had smoked within 30 days prior to angiography were considered current smokers. Prospectively, mortality was recorded over a mean follow-up time of 7.6±2.8 years. At baseline, both in patients with T2DM (n=522; 28.9% of the study cohort) and in nondiabetic subjects the prevalence of a past (44.1 and 39.5%; p=0.035) and, albeit less so, of current smoking (18.0 and 17.7%; p = 0.247) was high. Prospectively, current smoking independently predicted cardiovascular events after multivariate adjustment including baseline CAD in patients with diabetes (HR 1.78 [1.16-2.74]; p=0.009) as well as in nondiabetic patients (HR 1.68 [1.12-2.52]; p=0.013), whereas past smoking neither in patients with T2DM nor in nondiabetic subjects was associated with cardiovascular events (HRs 0.77 [0.54-1.10]; p=0.152 and HR 1.16 [0.87-1.53]; p=0.313, respectively). An interaction term diabetes x current smoking was not significant (p=0.564), indicating that current smoking was equally predictive of mortality in patients with T2DM and in nondiabetic subjects. We conclude that current but not past smoking strongly increases mortality risk angiographied coronary patients with T2DM independently from the baseline CAD state.


C.H. Saely: None. A. Vonbank: None. C. Heinzle: None. D. Zanolin: None. B. Larcher: None. A. Mader: None. A. Leiherer: None. A. Muendlein: None. H. Drexel: None.

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