Related Experiment Videos
[Cigarette smoking and acute myocardial infarct]
M Trappolini1, S Matteoli, F M Chillotti
1II Clinica Medica, Università degli Studi di Roma La Sapienza, Roma.
Insights
Current smokers experiencing Acute Myocardial Infarction (AMI) show a better in-hospital prognosis compared to non-smokers. This study suggests smoking may be associated with improved outcomes in AMI patients.
Area of Science:
- Cardiology
- Clinical Medicine
- Epidemiology
Context:
- Acute Myocardial Infarction (AMI) is a critical cardiovascular event.
- Cigarette smoking is a known risk factor for AMI.
- The in-hospital prognosis for smokers with AMI requires further investigation.
Purpose:
- To investigate the impact of cigarette smoking on the in-hospital prognosis of patients with Acute Myocardial Infarction (AMI).
- To compare outcomes between patients who were current smokers until AMI and those who were non-smokers or former smokers.
Summary:
- A study of 590 AMI patients revealed that current smokers were younger and had a significantly lower in-hospital mortality rate (7.6%) compared to non-smokers (22.6%).
- Non-smokers presented with more comorbidities, including hypertension, diabetes, and a history of angina or infarction.
- Higher rates of arrhythmias, ischemic complications, and congestive heart failure were observed in the non-smoker group.
Impact:
- Findings suggest a better in-hospital prognosis for smokers with AMI, challenging conventional risk factor assumptions.
- Results may prompt re-evaluation of risk stratification and management strategies for AMI patients.
- Further research into the pathogenetic mechanisms underlying this observed outcome is warranted.
Unlabelled:
Cigarette smoking is commonly considered as a major risk factor for Acute Myocardial Infarction (AMI). Although AMI has a high incidence in smokers, it doesn't seem to correlate with a worse in hospital prognosis. In order to investigate if cigarette smoking does affect the in-hospital prognosis in patients with AMI, 590 consecutive patients (451 males and 139 females; mean age 63.4 years) admitted to the Coronary Care Unit (CCU) with definite AMI have been studied. Patients were divided in two groups: Group A (303 patients, 269 males and 34 females) smokers till AMI and Group B (287 patients, 182 males and 105 females) nonsmokers or smokers till a month before AMI.
Results:
The mean age of nonsmokers was higher than smokers (68.4 years vs 58.8 years; p < 0.001). In addition they showed more frequently hypertension (48.8% vs 38%; p < 0.001), diabetes (31.3% vs 16.3%; p < 0.001), and healed infarction or angina (45.6% vs 37.5%). Among Group B higher global mortality rate was observed (22.6% vs 7.6%; p < 0.001) either among thrombolysed patients (10.1% vs 4.4%; p < 0.001) either among not thrombolysed (26.9% vs 4.4%; p < 0.001). The grading in age classes confirmed a higher mortality in nonsmokers patients (6.7% vs 4.9% age > or = 40 and < or = 65 years; 32.5% vs 13.3% > 65 years). They also presented more frequently arrhythmias (15.3% vs 12.2%), ischemic complications (25.4% vs 18.7%), and congestive heart failure (46% vs 34.2%).
Conclusions:
According to other authors the results of this study confirm a better prognosis in smokers with AMI. Up to authors hypothesis this outcome could be related either to the younger age, a to a different pathogenetic mechanism of coronaric occlusion to raised thrombosis.