M. Ishihara et al., CLINICAL IMPLICATIONS OF CIGARETTE-SMOKING IN ACUTE MYOCARDIAL-INFARCTION - ACUTE ANGIOGRAPHIC FINDINGS AND LONG-TERM PROGNOSIS, The American heart journal, 134(5), 1997, pp. 955-960
This study was undertaken to assess whether reperfusion in smokers cou
ld be achieved spontaneously or therapeutically and to assess whether
favorable outcome in smokers could be sustained for years after infarc
tion. We studied 260 patients with anterior myocardial infarction who
underwent coronary angiography and thrombolysis within 24 hours after
the onset of chest pain. There were 158 smokers and 102 nonsmokers. Sm
oking was associated more with men, younger age, and less multivessel
disease. On initial angiography, the distribution of Thrombolysis in M
yocardial Infarction grade was similar between smokers and nonsmokers.
After thrombolysis, Thrombolysis in Myocardial Infarction grade 3 was
more frequent in smokers (32% vs 18%; p = 0.004). In-hospital mortali
ty rates were lower (8% vs 18%, p = 0.022) and long-term cardiac survi
val was better in smokers (5-year survival. 82% vs 70%; p = 0.022). Ou
r data demonstrated that the infarct artery of smokers responded more
efficiently to thrombolysis and favorable outcome in smokers was susta
ined throughout 5 years.