Abstract 13317: Current Smoking Impedes Recovery in Cardiac Rehabilitation

Abstract

Purpose: Current smoking is a powerful predictor of future morbidity and mortality and those who smoke are more likely to have higher risk clinical profiles and less likely to engage in secondary prevention. Little is known about how those who smoke benefit from secondary prevention following a cardiac event, such as cardiac rehabilitation (CR). The purpose of this study was to compare improvements in fitness among those who smoke vs those who do not during CR. Methods: Data were gathered on 2208 individuals entering the University of Vermont CR program from 1/1996-12/2021. Self-reported smoking status was collected at CR entry (current vs. formerly vs. never smoking). Cardiorespiratory fitness (CRF)(peak oxygen capacity [VO2peak]) was assessed via exercise tolerance test at entry to and exit from CR. Change in Peak VO2 was compared by smoking status univariately and in a multivariate model controlling for other potential contributing variables like age, sex, entry VO2, number and severity of exercise-limiting comorbidities, BMI, and number of CR sessions attended. Results: On average patients improved by 3.26 in their CRF during the course of CR. In univariate analyses improvement by smoking status was 2.29, 3.06, and 3.55 (current, former, never smoker respectively). The final multivariate model included smoking status, CRF at intake, comorbidities, age, BMI, and interactions between smoking status and age, and BMI and age. Least square means from this model were improvements of 1.95, 3.10, and 3.53 (current, former, never smoker respectively). Conclusion: These data suggest that those who are currently smoking improve less in fitness during CR than those who formerly or never smoked and that controlling for covariates highlights that the biggest difference in the effect of smoking is truly between the current smokers and the former/never smokers. Further research should be conducted to see if successful smoking cessation can improve fitness related gains during CR.