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Published on: April 25, 2014
Smoking: a major predictor of left ventricular function after occlusion of the left anterior descending coronary
Insights
Smoking significantly worsens left ventricular damage after left anterior descending artery occlusion. This study identified smoking and artery distribution area as key predictors of impaired cardiac function post-myocardial infarction.
Area of Science:
- Cardiology
- Cardiovascular Medicine
- Interventional Cardiology
Background:
- Assessing predictors of left ventricular (LV) function post-myocardial infarction (MI) is crucial for patient outcomes.
- Left anterior descending (LAD) artery occlusion is a common cause of MI, impacting LV function.
Purpose of the Study:
- To identify major predictors of left ventricular function following complete left anterior descending artery occlusion.
- To determine the impact of smoking on left ventricular damage in patients with single-vessel coronary artery disease.
Main Methods:
- Retrospective analysis of 108 patients with single LAD occlusion.
- Utilized a scoring system on left ventriculograms to assess regional myocardial damage.
- Compared variables including smoking history, hypertension, and diabetes between patients with good and impaired LV function.
Main Results:
- Left ventricular (LV) function was impaired in 66 of 108 patients.
- Key predictors of impaired LV function were the area of LAD artery distribution and cigarette smoking.
- Hypertension, hypercholesterolemia, diabetes, and age were not significant discriminators.
Conclusions:
- Cigarette smoking is a significant factor in determining the extent of left ventricular damage after LAD occlusion.
- Beyond being a risk factor for myocardial infarction, smoking exacerbates cardiac damage in this patient population.
Abstract:
The major predictors of left ventricular function after coronary artery occlusion were assessed in 108 consecutive patients who had complete occlusion of the left anterior descending artery as the only important lesion demonstrated at angiography between June 1978 and June 1983. A scoring system was used to identify regional damage on left ventriculograms. Forty two patients were classified as having good left ventricular function and 66 as having varying degrees of impairment. Apart from a history of myocardial infarction, the only variables discriminating between those with good and those with impaired left ventricular function were the area of distribution of the artery beyond the occlusion and cigarette smoking. Hypertension, hypercholesterolaemia, family history of vascular disease, diabetes, obesity, duration of angina, age, and presence of identifiable collaterals were not discriminators. Smoking was itself significantly associated with a history of infarction; but after controlling for this, smoking exerted a significant additional effect on the amount of left ventricular damage. It is concluded that smoking is not only a risk factor for myocardial infarction in patients with single left anterior descending artery occlusion, but that it is also a major factor in determining the extent of associated left ventricular damage.
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