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Effect of Smoking Cessation on Left Ventricular Ejection Fraction after Acute ST Elevation Myocardial Infarction
Parisa Janjani1, Javad Azimivaghar1, Nahid Salehi1
1Cardiovascular Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
Insights
Smoking cessation after myocardial infarction (MI) did not significantly impact left ventricular ejection fraction (LVEF) after one year. Physicians should consistently advise MI patients to quit smoking due to low cessation rates.
Area of Science:
- Cardiology
- Public Health
Background:
- Acute Myocardial Infarction (AMI) remains a leading global cause of mortality.
- Left Ventricular Ejection Fraction (LVEF) is a critical predictor of post-AMI outcomes.
- Investigating the impact of smoking cessation on LVEF post-STEMI is crucial.
Purpose of the Study:
- To examine the association between smoking cessation and LVEF one year after ST-elevation myocardial infarction (STEMI).
Main Methods:
- Study included 825 smokers admitted with AMI, data from the Kermanshah STEMI Registry.
- Propensity Score Matching (PSM) and multiple logistic regression were employed to analyze LVEF differences between ex-smokers and current smokers.
- Standardized case report forms from the European Observational Registry Program (EORP) were utilized.
Main Results:
- One year post-AMI, 26.55% of patients quit smoking.
- After PSM, LVEF was slightly higher in current smokers than ex-smokers, but the difference was not statistically significant.
- Logistic regression indicated no significant difference in the odds of LVEF reduction between ex-smokers and current smokers.
Conclusions:
- The rate of smoking cessation following MI is notably low.
- Healthcare providers should routinely inquire about smoking status and strongly encourage smoking cessation in MI patients at all clinical encounters.
Background:
Acute Myocardial Infarction (AMI) is the leading cause of global mortality. Moreover, Left Ventricular Ejection Fraction (LVEF) is the most important predictor of post-AMI mortality. Thus, the present study aimed to investigate the relationship between smoking cessation and LVEF following one year from the STEMI.
Method:
The present study was a part of the Kermanshah STEMI Registry and included 825 smokers admitted to Imam Ali Hospital, Kermanshah, Iran, with AMI during a 2-year study period. Data collection was performed using the standardized case report form by the European Observational Registry Program (EORP). Moreover, multiple logistic regression was used to compare LVEF between the patients who had quit smoking post-AMI and those who were still smokers after one year. Also, one-to-one Propensity Score Matching (PSM) was used to reduce the assessment error and selection bias, increase the result accuracy, and minimize the effects of confounders on the LVEF-smoking relationship.
Results:
Following one year after AMI, 219 (26.55%) patients had quit smoking, while 606 (73.45%) still smoked. Using the PSM, a total of 168 ex-smokers were matched to 168 current smokers. Moreover, it was shown that LVEF was higher in current smokers compared to ex-smokers. However, the difference was not significant. Also, multiple logistic regression showed that the Odds Ratio (OR) of LVEF reduction was insignificantly higher in ex-smokers (OR=1.13; 95% CI: 0.98-1.29) compared to current smokers. Multivariate regression analysis found similar results even after the application of PSM (OR = 1.02; 95% CI: 0.82-1.22).
Conclusions:
Given the low rate of smoking cessation after MI, physicians are recommended to ask about the smoking status of MI patients at each office visit or re-admission and strongly recommend quitting smoking.
