Age-distribution, risk factors and mortality in smokers and non-smokers with acute myocardial infarction: a review

Smoking is a risk factor for acute myocardial infarction; paradoxically, ma ny studies have shown a lower post-infarct mortality among smokers. There a re some important differences between smokers and non-smokers, which might explain the observed difference in mortality: smokers have less multivessel disease and atherosclerosis but are more thrombogenic; thrombolytic therap y seems to be more effective among smokers; smoking might result in an incr eased out-of-hospital mortality rate, by being more arrhythmogenic; and smo kers are on average a decade younger than nonsmokers at the time of infarct ion, acid have less concomitant disease. Adjusting for these differences in regression analyses shows that smoking is not an independent risk factor f or mortality after acute myocardial infarction, The difference in age and r isk factors are responsible for the lower mortality among smokers. (C) 1999 Lippincott Williams & Wilkins.