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March 2, 2017Postgraduate Medical Journal

A retrospective cohort study of the association between smoking and mortality after acute ST-segment elevation myocardial infarction

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Why the study?

Does smoking status affect 1-year mortality in patients with acute STEMI managed by primary PCI?

Population

1,796 patients with acute ST-segment elevation myocardial infarction managed by primary percutaneous…

Comparison

Current smoking or ex-smoking vs Never smoking

Design

Cohort

Follow-up

1 year

Key result

Current smoking was not associated with 1-year mortality compared with never smoking in patients with acute STEMI treated with primary PCI (HR 1.47; 95% CI 0.90-2.39; p=0.23).

Authors

LSLloyd SteeleALAmelia LloydJFJames Fotheringham

Discussion

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Member takes

Overview

Smoking status should not alter prognosis or risk stratification after primary PCI for STEMI; this cohort study leaves open whether a smoker's paradox exists after adjustment.

Study Design

Type

Cohort (n=1,796)

Multicenter

No

Structured PICO

Does smoking status affect 1-year mortality in patients with acute STEMI managed by primary PCI?

P
Population
1,796 patients with acute ST-segment elevation myocardial infarction (STEMI) managed by primary percutaneous coronary intervention (PCI) at a single UK center.
I
Intervention
Current smoking or ex-smoking
C
Comparator
Never smoking
O
Outcome
1-year mortalityhard clinical

Main Result

Effect estimate: HR 1.47 (95% CI 0.90 to 2.39)

p-value: p=0.23

In patients with STEMI undergoing primary PCI, smoking status was not significantly associated with 1-year mortality after adjusting for age and other risk factors, challenging the existence of a 'smoker's paradox'.

Cite This Study

Steele et al. (2017) conducted a cohort in Acute ST-segment elevation myocardial infarction (STEMI) (n=1,796). Current smoking vs. Never smoking was evaluated on 1-year mortality (HR 1.47, 95% CI 0.90 to 2.39, p=0.23). Current smoking was not associated with 1-year mortality compared with never smoking in patients with acute STEMI treated with primary PCI (HR 1.47; 95% CI 0.90-2.39; p=0.23).

synapsesocial.com/papers/6a1c053ab33628da419d1ef8https://doi.org/10.1136/postgradmedj-2016-134605
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