Impact of Smoking Status on Mortality in STEMI Patients Undergoing Mechanical Reperfusion for STEMI: Insights from the ISACS-STEMI COVID-19 Registry

• Authors: GIUSEPPE De Luca; ALGOWHARY Magdy; UGUZ Berat; OLIVEIRA Dinaldo C; GANYUKOV Vladimir; ZIMBAKOV Zan; CERCEK Miha; JENSEN Lisette Okkels; LOH Poay Huan; CALMAC Lucian; FERRER Gerard Roura I; QUADROS Alexandre; MILEWSKI Marek; UCCIO Fortunato Scotto; CLEMENS von Birgelen; VERSACI Francesco; JURRIEN Ten Berg; CASELLA Gianni; LUNG Aaron Wong Sung; KALA Petr; GIL Jose Luis Diez; CARRILLO Xavier; DIRKSEN Maurits; BECERRA-MUNOZ Victor M; LEE Michael Kang-Yin; JUZAR Dafsah Arifa; JOAQUIM Rodrigo de Moura; PALADINO Roberto; MILICIC Davor; DAVLOUROS Periklis; BAKRACESKI Nikola; ZILIO Filippo; DONAZZAN Luca; KRAAIJEVELD Adriaan; GALASSO Gennaro; ARPAD Lux; LUCIA Marinucci; VINCENZO Guiducci; MENICHELLI Maurizio; SCOCCIA Alessandra; YAMAC Aylin Hatice; MERT Kadir Ugur; RIOS Xacobe Flores; KOVARNIK Tomas; KIDAWA Michal; MOREU Jose; VINCENT Flavien; FABRIS Enrico; INIGO Lozano Martinez-Luengas; BOCCALATTE Marco; OJEDA Francisco Bosa; ARELLANO-SERRANO Carlos; CAIAZZO Gianluca; CIRRINCIONE Giuseppe; KAO Hsien-Li; FORES Juan Sanchis; VIGNALI Luigi; PEREIRA Helder; MANZO Stephane; ORDONEZ Santiago; OZKAN Alev Arat; SCHELLER Bruno; LEHTOLA Heidi; TELES Rui; MANTIS Christos; ANTTI Ylitalo; ANTONIO Brum Silveira Joao; ZONI Rodrigo; BESSONOV Ivan; SAVONITTO Stefano; KOCHIADAKIS George; ALEXOPULOS Dimitrios; 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
• Year of publication: 2022
• Type: Article in Periodical
• Magazine / Source: Journal of Clinical Medicine
• MU Faculty or unit: Faculty of Medicine
• Web: https://www.mdpi.com/2077-0383/11/22/6722
• Doi: http://dx.doi.org/10.3390/jcm11226722
• Keywords: myocardial infarction; smoking paradox; percutaneous coronary intervention; COVID-19
• Description: 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.