1. Impact of Smoking Status on Mortality in STEMI Patients Undergoing Mechanical Reperfusion for STEMI: Insights from the ISACS-STEMI COVID-19 Registry
- Author
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Giuseppe De Luca, Magdy Algowhary, Berat Uguz, Dinaldo C. Oliveira, Vladimir Ganyukov, Zan Zimbakov, Miha Cercek, Lisette Okkels Jensen, Poay Huan Loh, Lucian Calmac, Gerard Roura i Ferrer, Alexandre Quadros, Marek Milewski, Fortunato Scotto D’Uccio, Clemens von Birgelen, Francesco Versaci, Jurrien Ten Berg, Gianni Casella, Aaron Wong Sung Lung, Petr Kala, José Luis Díez Gil, Xavier Carrillo, Maurits Dirksen, Victor M. Becerra-Munoz, Michael Kang-yin Lee, Dafsah Arifa Juzar, Rodrigo de Moura Joaquim, Roberto Paladino, Davor Milicic, Periklis Davlouros, Nikola Bakraceski, Filippo Zilio, Luca Donazzan, Adriaan Kraaijeveld, Gennaro Galasso, Lux Arpad, Marinucci Lucia, Guiducci Vincenzo, Maurizio Menichelli, Alessandra Scoccia, Aylin Hatice Yamac, Kadir Ugur Mert, Xacobe Flores Rios, Tomas Kovarnik, Michal Kidawa, Josè Moreu, Flavien Vincent, Enrico Fabris, Iñigo Lozano Martínez-Luengas, Marco Boccalatte, Francisco Bosa Ojeda, Carlos Arellano-Serrano, Gianluca Caiazzo, Giuseppe Cirrincione, Hsien-Li Kao, Juan Sanchis Forés, Luigi Vignali, Helder Pereira, Stephane Manzo, Santiago Ordoñez, Alev Arat Özkan, Bruno Scheller, Heidi Lehtola, Rui Teles, Christos Mantis, Ylitalo Antti, João António Brum Silveira, Rodrigo Zoni, Ivan Bessonov, Stefano Savonitto, George Kochiadakis, Dimitrios Alexopulos, Carlos E. Uribe, John Kanakakis, Benjamin Faurie, Gabriele Gabrielli, Alejandro Gutierrez Barrios, Juan Pablo Bachini, Alex Rocha, Frankie Chor-Cheung Tam, Alfredo Rodriguez, Antonia Anna Lukito, Veauthyelau Saint-Joy, Gustavo Pessah, Andrea Tuccillo, Giuliana Cortese, Guido Parodi, Mohamed Abed Bouraghda, Elvin Kedhi, Pablo Lamelas, Harry Suryapranata, Matteo Nardin, Monica Verdoia, De Luca, Giuseppe, Algowhary, Magdy, Uguz, Berat, Oliveira, Dinaldo C, Ganyukov, Vladimir, Zimbakov, Zan, Cercek, Miha, Jensen, Lisette Okkel, Loh, Poay Huan, Calmac, Lucian, Ferrer, Gerard Roura I, Quadros, Alexandre, Milewski, Marek, Scotto D'Uccio, Fortunato, von Birgelen, Clemen, Versaci, Francesco, Ten Berg, Jurrien, Casella, Gianni, Wong Sung Lung, Aaron, Kala, Petr, Díez Gil, José Lui, Carrillo, Xavier, Dirksen, Maurit, Becerra-Munoz, Victor M, Lee, Michael Kang-Yin, Juzar, Dafsah Arifa, Joaquim, Rodrigo de Moura, Paladino, Roberto, Milicic, Davor, Davlouros, Perikli, Bakraceski, Nikola, Zilio, Filippo, Donazzan, Luca, Kraaijeveld, Adriaan, Galasso, Gennaro, Arpad, Lux, Lucia, Marinucci, Vincenzo, Guiducci, Menichelli, Maurizio, Scoccia, Alessandra, Yamac, Aylin Hatice, Ugur Mert, Kadir, Flores Rios, Xacobe, Kovarnik, Toma, Kidawa, Michal, Moreu, Josè, Vincent, Flavien, Fabris, Enrico, Martínez-Luengas, Iñigo Lozano, Boccalatte, Marco, Bosa Ojeda, Francisco, Arellano-Serrano, Carlo, Caiazzo, Gianluca, Cirrincione, Giuseppe, Kao, Hsien-Li, Sanchis Forés, Juan, Vignali, Luigi, Pereira, Helder, Manzo, Stephane, Ordoñez, Santiago, Özkan, Alev Arat, Scheller, Bruno, Lehtola, Heidi, Teles, Rui, Mantis, Christo, Antti, Ylitalo, Silveira, João António Brum, Zoni, Rodrigo, Bessonov, Ivan, Savonitto, Stefano, Kochiadakis, George, Alexopulos, Dimitrio, Uribe, Carlos E, Kanakakis, John, Faurie, Benjamin, Gabrielli, Gabriele, Barrios, Alejandro Gutierrez, Bachini, Juan Pablo, Rocha, Alex, Tam, Frankie Chor-Cheung, Rodriguez, Alfredo, Lukito, Antonia Anna, Saint-Joy, Veauthyelau, Pessah, Gustavo, Tuccillo, Andrea, Cortese, Giuliana, Parodi, Guido, Bouraghda, Mohamed Abed, Kedhi, Elvin, Lamelas, Pablo, Suryapranata, Harry, Nardin, Matteo, Verdoia, Monica, MUMC+: MA Med Staf Spec Cardiologie (9), RS: Carim - H01 Clinical atrial fibrillation, and YAMAÇ, AYLİN HATİCE
- Subjects
ACUTE MYOCARDIAL-INFARCTION ,myocardial infarction ,smoking paradox ,percutaneous coronary intervention ,COVID-19 ,Temel Tıp Bilimleri ,Medicine (miscellaneous) ,Assessment and Diagnosis ,Sağlık Bilimleri ,Temel Bilgi ve Beceriler ,Genel Tıp ,Fundamental Medical Sciences ,Pathophysiology ,Clinical Medicine (MED) ,TIP, GENEL & DAHİLİ ,Hàbit de fumar ,Health Sciences ,Internal Medicine ,Klinik Tıp (MED) ,ST-SEGMENT ELEVATION ,Aile Sağlığı ,MEDICINE, GENERAL & INTERNAL ,Dahiliye ,Patofizyoloji ,OUTCOMES ,Klinik Tıp ,Fundamentals and Skills ,Smoking ,EXTENT ,General Medicine ,CLINICAL MEDICINE ,Değerlendirme ve Teşhis ,Tıp ,TIME ,Infart de miocardi ,THROMBOLYTIC THERAPY ,CARDIOVASCULAR-DISEASE ,General Health Professions ,Medicine ,CORONARY-ARTERY-DISEASE ,Tıp (çeşitli) ,CIGARETTE-SMOKING ,Family Practice ,Genel Sağlık Meslekleri ,SMOKERS - 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.
- Published
- 2022