Impact of Smoking Status on Mortality in STEMI Patients Undergoing Mechanical Reperfusion for STEMI: Insights from the ISACS–STEMI COVID-19 Registry
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Published:2022-11-13
Issue:22
Volume:11
Page:6722
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ISSN:2077-0383
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Container-title:Journal of Clinical Medicine
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language:en
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Short-container-title:JCM
Author:
De Luca GiuseppeORCID, Algowhary MagdyORCID, Uguz Berat, Oliveira Dinaldo C., Ganyukov VladimirORCID, Zimbakov Zan, Cercek Miha, Jensen Lisette Okkels, Loh Poay Huan, Calmac LucianORCID, Ferrer Gerard Roura i, Quadros Alexandre, Milewski MarekORCID, Scotto D’Uccio Fortunato, von Birgelen Clemens, Versaci Francesco, Ten Berg Jurrien, Casella GianniORCID, Wong Sung Lung Aaron, Kala Petr, Díez Gil José Luis, Carrillo XavierORCID, 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 FilippoORCID, Donazzan LucaORCID, Kraaijeveld Adriaan, Galasso GennaroORCID, Arpad Lux, Lucia Marinucci, Vincenzo GuiducciORCID, Menichelli Maurizio, Scoccia AlessandraORCID, Yamac Aylin Hatice, Ugur Mert KadirORCID, Flores Rios Xacobe, Kovarnik Tomas, Kidawa MichalORCID, Moreu JosèORCID, Vincent Flavien, Fabris EnricoORCID, Martínez-Luengas Iñigo Lozano, Boccalatte Marco, Bosa Ojeda Francisco, Arellano-Serrano Carlos, Caiazzo GianlucaORCID, Cirrincione Giuseppe, Kao Hsien-Li, Sanchis Forés JuanORCID, Vignali Luigi, Pereira Helder, Manzo StephaneORCID, Ordoñez SantiagoORCID, Özkan Alev AratORCID, Scheller Bruno, Lehtola Heidi, Teles RuiORCID, Mantis Christos, Antti Ylitalo, Silveira João António Brum, Zoni Rodrigo, Bessonov Ivan, Savonitto Stefano, Kochiadakis George, Alexopulos Dimitrios, Uribe Carlos E.ORCID, Kanakakis John, Faurie Benjamin, Gabrielli Gabriele, Barrios Alejandro Gutierrez, Bachini Juan Pablo, Rocha Alex, Tam Frankie Chor-Cheung, Rodriguez Alfredo, Lukito Antonia AnnaORCID, Saint-Joy Veauthyelau, Pessah Gustavo, Tuccillo Andrea, Cortese GiulianaORCID, Parodi GuidoORCID, Bouraghda Mohamed AbedORCID, Kedhi Elvin, Lamelas Pablo, Suryapranata HarryORCID, Nardin MatteoORCID, Verdoia Monica
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.
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