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Tobacco Cessation and Prevention |

Burden of Smoking in Acute Coronary Syndrome

Edelweise Merin*, MD; Ma. Encarnita Limpin, MD; Fernando Ayuyao, MD; Teresita de Guia, MD
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Philippine Heart Center, Quezon City, Philippines


Chest. 2012;142(4_MeetingAbstracts):1083A. doi:10.1378/chest.1389392
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Abstract

SESSION TYPE: Tobacco Cessation and Prevention

PRESENTED ON: Tuesday, October 23, 2012 at 04:30 PM - 05:45 PM

PURPOSE: The purpose of this study was to evaluate the burden of smoking among patients who had acute coronary syndrome seen at Philippine Heart Center in terms of its outcomes and expenditures.

METHODS: 199 patients participated in the study. Smoking habits were recorded including their co-morbidities, GRACE and TIMI scores. Financial data were gathered, tabulated and evaluated. Outcomes of ACS were tabulated in relation to patients’ smoking history and were evaluated.

RESULTS: Of the 199 patients, 60% were direct smokers, 12% were passive smokers and 28% were non-smokers. There were no differences in terms of outcomes and length of hospital stay, ICU stays and need for mechanical ventilation. In this study, the accumulated hospital expenses excluding physicians professional fees for ACS patients who smoke was USD 795,659.21. The mean amount expended for each person admitted for acute coronary syndrome who smokes (direct and passive) was USD 5,629.58 + 6,290.32. For the mean accumulated hospital expenses of those ACS patients who smoke (direct and passive) who died was USD 11,786.55 + 10,196.50) as compared with those ACS patients who smoke who survived and was discharged improved the mean accumulated hospital expenses was USD 4,941.63 + 5,160.79) (P-value of 0.000).

CONCLUSIONS: In this study, it shows that among those patients who have acute coronary syndromes, predominantly were smokers, both direct and passive smokers comprising 72% of the patients. In a developing country like ours, the mean amount expended for each person admitted for acute coronary syndrome who smokes (direct and passive) was two hundred forty-seven thousand two hundred sixty pesos (PhP 247, 260.00 + 276,428.00 excluding physician’s professional fee) which is already a sumptuous that drains one’s finances. And of these, for every smoker patients who had acute coronary syndrome, the mean expenses for each person with each admission were PhP 217,160.00 + 226,791.09 for those who survived and were discharged and PhP 517,960.00 + 448,085.23 for those who died. Therefore, smoking is still prevalent among patients who have acute coronary syndrome and with each admission, each patient expend a sumptuous amount of money for the health resources.

CLINICAL IMPLICATIONS: Smoking has a significant burden on patient's health and financial status. It was identified as a preventable risk factor for acute coronary syndrome, hence continuous encouragement on smoking cessation and patient's awareness on its effects on health care is a must for every physician.

DISCLOSURE: The following authors have nothing to disclose: Edelweise Merin, Ma. Encarnita Limpin, Fernando Ayuyao, Teresita de Guia

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Philippine Heart Center, Quezon City, Philippines

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