J Transcat Intervent.2019;27:eA201823.
Association between smoking and hospital mortality in myocardial infarction patients undergoing primary angioplasty
The association between smoking and better clinical outcomes in myocardial infarction patients undergoing fibrinolysis is known as the smoking paradox. The relation between smoking and clinical outcomes after primary angioplasty is controversial. The study aimed to assess the association between smoking and hospital mortality in patients admitted due to ST-segment elevation myocardial infarction submitted to primary angioplasty.
A single-center registry including all patients submitted to primary angioplasty from January to July 2014. A comparative analysis was carried out of the baseline clinical, angiographic, and procedural characteristics between the groups of smokers and non-smokers. An exploratory analysis of the factors associated to hospital mortality was performed through univariate logistic regression.
A total of 193 patients were included; in that, 45% smokers, mean age 62±11.9 years. The groups were similar regarding the clinical, angiographic, and procedural characteristics, except for dyslipidemia and use of angiotensin converting enzyme inhibitors or angiotensin II receptor blocker that were higher in the group of smokers. Hospital mortality was 7.8%, and there was no association with smoking (p=0.346). The variables associated to hospital mortality were low ejection fraction (OR: 8.22; p=0.022), left main coronary artery lesion (OR: 7.72; p=0.003), creatinine ≥1.5mg/dL (OR: 40.80; p<0.001), final TIMI flow 0-1 (OR: 7.72; p=0.003) and age ≥75 years (OR: 4.18; p=0.010).
There was no association between smoking and hospital mortality in patients submitted to primary angioplasty.