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Smoking is not a protective factor for patients with acute myocardial infarction: the viewpoint of the GISSI-2 Study

A P Maggioni1, F Piantadosi, G Tognoni

  • 1Research Center ANMCO, Florence.

Giornale Italiano Di Cardiologia
|October 27, 1998
PubMed

Insights

Smoking may appear protective after myocardial infarction, but this study found no confirmed benefit. After adjusting for other factors, smoking did not reduce mortality, reinfarction, or stroke risk in patients treated with thrombolytic agents.

Area of Science:

  • Cardiology
  • Epidemiology
  • Public Health

Background:

  • A previous study suggested smoking protects against mortality after acute myocardial infarction (MI).
  • This protection was hypothesized to be due to smokers achieving early complete perfusion after thrombolytic treatment.
  • The current analysis investigates the effect of smoking on outcomes following MI.

Purpose of the Study:

  • To evaluate the impact of smoking on in-hospital mortality.
  • To assess the effect of smoking on reinfarction rates.
  • To determine the influence of smoking on stroke rates in patients with acute myocardial infarction.

Main Methods:

  • Analysis of the GISSI-2 database including 2611 nonsmokers, 1932 ex-smokers, and 5151 active smokers.
  • Evaluation of the relationship between smoking habits and outcomes using unadjusted and adjusted analyses.
  • Assessment of in-hospital mortality, reinfarction, and stroke rates based on smoking status.

Main Results:

  • Smokers had significantly lower reinfarction (1.5%) and stroke (0.8%) rates compared to ex-smokers and nonsmokers.
  • In-hospital mortality was significantly higher in nonsmokers (13.8%) and ex-smokers (7.6%) than in active smokers (4.7%).
  • After adjusted analysis, smoking was not confirmed as a protective factor for reinfarction (OR 1.35), stroke (OR 0.79), or mortality (OR 0.80).

Conclusions:

  • Active smokers exhibited lower rates of reinfarction, stroke, and in-hospital mortality.
  • The apparent protective effect of smoking was not confirmed after adjusting for clinical-epidemiological variables.
  • Smoking is not a confirmed protective factor for adverse outcomes following acute myocardial infarction treated with thrombolysis.
Abstract

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