CLINICAL IMPLICATIONS OF CIGARETTE-SMOKING IN ACUTE MYOCARDIAL-INFARCTION - ACUTE ANGIOGRAPHIC FINDINGS AND LONG-TERM PROGNOSIS

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.