Impact of Smoking Status on Mortality in STEMI Patients Undergoing Mechanical Reperfusion for STEMI: Insights from the ISACS-STEMI COVID-19 Registry
Publication date
2022-11-13
Authors
De Luca, Giuseppe
Algowhary, Magdy
Uguz, Berat
Oliveira, Dinaldo C
Ganyukov, Vladimir
Zimbakov, Zan
Cercek, Miha
Jensen, Lisette Okkels
Loh, Poay Huan
Calmac, Lucian
Editors
Advisors
Supervisors
Document Type
Article
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Abstract
The so-called “smoking paradox”, conditioning lower mortality in smokers among STEMI patients, has seldom been addressed in the settings of modern primary PCI protocols. The ISACS–STEMI COVID-19 is a large-scale retrospective multicenter registry addressing in-hospital mortality, reperfusion, and 30-day mortality among primary PCI patients in the era of the COVID-19 pandemic. Among the 16,083 STEMI patients, 6819 (42.3%) patients were active smokers, 2099 (13.1%) previous smokers, and 7165 (44.6%) non-smokers. Despite the impaired preprocedural recanalization (p < 0.001), active smokers had a significantly better postprocedural TIMI flow compared with non-smokers (p < 0.001); this was confirmed after adjustment for all baseline and procedural confounders, and the propensity score. Active smokers had a significantly lower in-hospital (p < 0.001) and 30-day (p < 0.001) mortality compared with non-smokers and previous smokers; this was confirmed after adjustment for all baseline and procedural confounders, and the propensity score. In conclusion, in our population, active smoking was significantly associated with improved epicardial recanalization and lower in-hospital and 30-day mortality compared with previous and non-smoking history.
Keywords
COVID-19, myocardial infarction, percutaneous coronary intervention, smoking paradox, General Medicine
Citation
De Luca, G, Algowhary, M, Uguz, B, Oliveira, D C, Ganyukov, V, Zimbakov, Z, Cercek, M, Jensen, L O, Loh, P H, Calmac, L, Ferrer, G R I, Quadros, A, Milewski, M, Scotto D'Uccio, F, von Birgelen, C, Versaci, F, Ten Berg, J, Casella, G, Wong Sung Lung, A, Kala, P, Díez Gil, J L, Carrillo, X, Dirksen, M, Becerra-Munoz, V M, Lee, M K-Y, Juzar, D A, Joaquim, R D M, Paladino, R, Milicic, D, Davlouros, P, Bakraceski, N, Zilio, F, Donazzan, L, Kraaijeveld, A, Galasso, G, Arpad, L, Lucia, M, Vincenzo, G, Menichelli, M, Scoccia, A, Yamac, A H, Ugur Mert, K, Flores Rios, X, Kovarnik, T, Kidawa, M, Moreu, J, Vincent, F, Fabris, E, Martínez-Luengas, I L, Boccalatte, M, Bosa Ojeda, F, Arellano-Serrano, C, Caiazzo, G, Cirrincione, G, Kao, H-L, Sanchis Forés, J, Vignali, L, Pereira, H, Manzo, S, Ordoñez, S, Özkan, A A, Scheller, B, Lehtola, H, Teles, R, Mantis, C, Antti, Y, Silveira, J A B, Zoni, R, Bessonov, I, Savonitto, S, Kochiadakis, G, Alexopulos, D, Uribe, C E, Kanakakis, J, Faurie, B, Gabrielli, G, Barrios, A G, Bachini, J P, Rocha, A, Tam, F C-C, Rodriguez, A, Lukito, A A, Saint-Joy, V, Pessah, G, Tuccillo, A, Cortese, G, Parodi, G, Bouraghda, M A, Kedhi, E, Lamelas, P, Suryapranata, H, Nardin, M & Verdoia, M 2022, 'Impact of Smoking Status on Mortality in STEMI Patients Undergoing Mechanical Reperfusion for STEMI : Insights from the ISACS-STEMI COVID-19 Registry', Journal of Clinical medicine, vol. 11, no. 22, 6722. https://doi.org/10.3390/jcm11226722