Effects of Smoking on Very-Long Term Mortality after First ST Elevation Myocardial Infarction Efeitos do Ato de Fumar na Mortalidade de Longo Prazo após Infarto do Miocárdio por Elevação de ST

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KIZILTUNÇ E., Şahin Y. B., TOPAL S., Düzenli M. A., Karakaya E., Aygül N., ...More

Arquivos Brasileiros de Cardiologia, vol.118, no.1, pp.24-32, 2022 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 118 Issue: 1
  • Publication Date: 2022
  • Doi Number: 10.36660/abc.20201036
  • Journal Name: Arquivos Brasileiros de Cardiologia
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, Directory of Open Access Journals
  • Page Numbers: pp.24-32
  • Keywords: Tobacco Use Disorder, Nicotine/adverse effects, ST Elevation Myocardial Infarction/complications, Risk Factors, Mortality, PERCUTANEOUS CORONARY INTERVENTION, RECEIVING THROMBOLYTIC THERAPY, SMOKERS PARADOX, CIGARETTE-SMOKING, FOLLOW-UP, OUTCOMES, TRIAL
  • Kayseri University Affiliated: No


© 2022, Arquivos Brasileiros de Cardiologia. All rights reserved.Background: The smoking paradox has been a matter of debate for acute myocardial infarction patients for more than two decades. Although there is huge evidence claiming that is no real paradox, publications supporting better outcomes in post-MI smokers are still being released. Objective: To explore the effect of smoking on very long-term mortality after ST Elevation myocardial infarction (STEMI). Methods: This study included STEMI patients who were diagnosed between the years of 2004-2006 at three tertiary centers. Patients were categorized according to tobacco exposure (Group 1: non-smokers; Group 2: <20 package*years users, Group 3: 20-40 package*years users, Group 4: >40 package*years users). A Cox regression model was used to estimate the relative risks for very long-term mortality. P value <0.05 was considered as statistically significant. Results: There were 313 patients (201 smokers, 112 non-smokers) who were followed-up for a median period of 174 months. Smokers were younger (54±9 vs. 62±11, p: <0.001), and the presence of cardiometabolic risk factors were more prevalent in non-smokers. A univariate analysis of the impact of the smoking habit on mortality revealed a better survival curve in Group 2 than in Group 1. However, after adjustment for confounders, it was observed that smokers had a significantly increased risk of death. The relative risk became higher with increased exposure (Group 2 vs. Group 1; HR: 1.141; 95% CI: 0.599 to 2.171, Group 3 vs Group 1; HR: 2.130; 95% CI: 1.236 to 3.670, Group 4 vs Group 1; HR: 2.602; 95% CI: 1.461 to 4.634). Conclusion: Smoking gradually increases the risk of all-cause mortality after STEMI.