Impact of Smoking Status on Mortality in STEMI Patients Undergoing Mechanical Reperfusion for STEMI: Insights from the ISACS–STEMI COVID-19 Registry

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...

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Detalles Bibliográficos
Autores principales: De Luca, Giuseppe, Algowhary, Magdy, Uguz, Berat, Oliveira, Dinaldo C., Ganyukov, Vladimir, Zimbakov, Zan, Cercek, Miha, Jensen, Lisette Okkels, Loh, Poay Huan, Calmac, Lucian, Ferrer, Gerard Roura i, Quadros, Alexandre, Milewski, Marek, Scotto D’Uccio, Fortunato, von Birgelen, Clemens, Versaci, Francesco, Ten Berg, Jurrien, Casella, Gianni, Wong Sung Lung, Aaron, Kala, Petr, Díez Gil, José Luis, Carrillo, Xavier, Dirksen, Maurits, Becerra-Munoz, Victor M., Lee, Michael Kang-yin, Juzar, Dafsah Arifa, Joaquim, Rodrigo de Moura, Paladino, Roberto, Milicic, Davor, Davlouros, Periklis, Bakraceski, Nikola, Zilio, Filippo, Donazzan, Luca, Kraaijeveld, Adriaan, Galasso, Gennaro, Arpad, Lux, Lucia, Marinucci, Vincenzo, Guiducci, Menichelli, Maurizio, Scoccia, Alessandra, Yamac, Aylin Hatice, Ugur Mert, Kadir, Flores Rios, Xacobe, Kovarnik, Tomas, Kidawa, Michal, Moreu, Josè, Vincent, Flavien, Fabris, Enrico, Martínez-Luengas, Iñigo Lozano, Boccalatte, Marco, Bosa Ojeda, Francisco, Arellano-Serrano, Carlos, Caiazzo, Gianluca, Cirrincione, Giuseppe, Kao, Hsien-Li, Sanchis Forés, Juan, Vignali, Luigi, Pereira, Helder, Manzo, Stephane, Ordoñez, Santiago, Özkan, Alev Arat, Scheller, Bruno, Lehtola, Heidi, Teles, Rui, Mantis, Christos, Antti, Ylitalo, Silveira, João António Brum, Zoni, Rodrigo, Bessonov, Ivan, Savonitto, Stefano, Kochiadakis, George, Alexopulos, Dimitrios, Uribe, Carlos E., Kanakakis, John, Faurie, Benjamin, Gabrielli, Gabriele, Barrios, Alejandro Gutierrez, Bachini, Juan Pablo, Rocha, Alex, Tam, Frankie Chor-Cheung, Rodriguez, Alfredo, Lukito, Antonia Anna, Saint-Joy, Veauthyelau, Pessah, Gustavo, Tuccillo, Andrea, Cortese, Giuliana, Parodi, Guido, Bouraghda, Mohamed Abed, Kedhi, Elvin, Lamelas, Pablo, Suryapranata, Harry, Nardin, Matteo, Verdoia, Monica
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Article
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9698021/
https://www.ncbi.nlm.nih.gov/pubmed/36431198
http://dx.doi.org/10.3390/jcm11226722
Descripción
Sumario: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.

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