January 15, 1995Circulation
Effect of Cigarette Smoking on Outcome After Thrombolytic Therapy for Myocardial Infarction
Key result
Current smoking is not independently linked to lower in-hospital mortality after adjusting for baseline differences.
- P=0.0001
- n=1,619
Why the study?
Does current smoking improve outcomes in patients receiving thrombolytic therapy for myocardial infarction?
Population
1,619 patients treated with TPA, urokinase, or both in six consecutive myocardial infarction trials, of whom…
Comparison
Current smoking vs Non-smoking
Design
Cohort, Catheterizations were quantified blinded to the patients' smoking status
Follow-up
In-hospital / predischarge
Authors
Discussion
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Implication
Apparent mortality benefit of smoking in thrombolyzed MI is confounded by baselines; leaves open any independent effect after adjustment.
Study Design
Type
Cohort (n=1,619)
Blinding
Single-blind
Multicenter
Yes
Structured PICO
Does current smoking improve outcomes in patients receiving thrombolytic therapy for myocardial infarction?
P
Population
1,619 patients treated with TPA, urokinase, or both in six consecutive myocardial infarction trials, of whom 878 (54%) were currently smoking.
I
Intervention
Current smoking
C
Comparator
Non-smoking
O
Outcome
90-minute patency, TIMI-3 flow, minimum lumen diameter, and in-hospital mortalityhard clinical
Main Result
Absolute Event Rate: 4% vs 8.9%
p-value: p=0.0001
The apparent survival benefit of smoking in patients receiving thrombolysis for myocardial infarction is driven by favorable baseline characteristics (younger age, less severe disease) rather than an independent protective effect.
Cite This Study
Grines et al. (1995) conducted a cohort in Myocardial Infarction (n=1,619). Current smoking vs. Nonsmoking was evaluated on In-hospital mortality (p=0.0001). Current smoking was associated with lower in-hospital mortality than nonsmoking (4.0% vs 8.9%, P=0.0001), but this lost independent prognostic significance after adjusting for baseline differences.