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If Quitting Is Too Hard, Could E-Cigarettes Be a Safer Option?

Switching to e-cigarettes after PCI linked to lower cardiovascular risk

Medicine
Prof. CHOI, KI HONG

  • If Quitting Is Too Hard, Could E-Cigarettes Be a Safer Option?
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A recent Korean nationwide study published in the European Heart Journal (Impact Factor = 39.3) reports that patients who switch from combustible cigarettes to e-cigarettes after percutaneous coronary intervention (PCI), or who successfully quit smoking altogether, show significantly lower risks of cardiovascular complications.


Using data from the National Health Insurance Service (NHIS), the study analyzed 17,973 adult smokers who underwent PCI. Participants were categorized into three groups: those who continued smoking combustible cigarettes, those who switched to e-cigarettes, and those who successfully quit smoking. The incidence of major adverse cardiovascular events (MACEs), including myocardial infarction, all-cause death, and repeat revascularization, was compared across these groups.


The findings revealed that patients who entirely switched to e-cigarettes had an approximately 18% lower risk of MACEs compared with those who continued smoking combustible cigarettes. The reduction in risk was comparable to that observed in the complete smoking cessation group.


Dr. Choi, the corresponding author emphasized the clinical implications:

“Many patients continue to smoke even after suffering myocardial infarction, which  increases the risk of stent thrombosis and other fatal complications. While smoking cessation is the best option, switching to less harmful alternatives such as e-cigarettes may be a pragmatic secondary approach for those unable to quit.”


This publication is also a compelling example of interdisciplinary collaboration between physician and epidemiologist. The study was co-led by Prof. Ki Hong Choi (Cardiology, SKKU School of Medicine and Samsung Medical Center) and Prof. Danbee Kang (Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Sciences & Technology, SAIHST). 


Together, the team has consistently addressed clinical questions using diverse methodological approaches. Their efforts include numerous joint publications in top-tier journals with impact factors exceeding 10, including articles ranked in the top 5% of their respective fields.


Beyond this study, they continue to lead a broad spectrum of projects that translate bedside questions into evidence through real-world data. Their work spans from evaluating treatment effectiveness to assessing health system interventions, all while maintaining a practical, patient-centered perspective.



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