The Outcome of Smoker Patients With ST-Elevation Myocardial Infarction (STEMI) Undergone Primary Percutaneous Coronary Intervention (P-PCI) Versus Thrombolytic Therapy

Background: Because of the high prevalence of cardiovascular diseases and their urgent treatment in a way that have minimal side effects and maximum benefits, this study aims to compare the mortality rate, re-hospitalization, and ejection fraction of smoker patients undergone P-PCI (primary percutaneous coronary intervention) with those who received thrombolytic therapy in autumn 2018. Methods: This cross-sectional study was done in Ayatollah Taleghani and Labbafinejad hospitals of Tehran City, Iran. The study group consisted of 42 smoker patients referred to the hospitals with the diagnosis of ST-Elevation Myocardial Infarction (STEMI) and have undergone P-PCI or thrombolytic therapy from September 2018 to December 2018. Complications such as death and re-hospitalization were noted, and the ejection fraction of each patient was also recorded. Statistical analyses were performed using SPSS version 25. Statistical significance was considered at P< 0.05. Results: The Independent Samples t-test showed no significant difference between two groups of PCI and thrombolytic therapy regarding ejection fraction (EF) at the time of admission. Also, there was no considerable EF difference after three months of follow-up between 2 groups in both smoker and ex-smoker ones (P>0.05). Mean (SD) values of EF in smoker patients who underwent PCI were 41.56 9.95 at the time of admission and 45.00 10.52 after three months of follow-up. The paired sample t-test showed no significant difference between both groups regarding EF at the time of admission and after three months. The mean (SD) values of EF in smoker patients who underwent thrombolytic therapy were 40.26 8.73 at the time of admission and 48.53 5.80 after three months of follow-up. The paired sample t-test showed no significant difference between EF at the time of admission and after three months in the ex-smoker group, but there was a considerable difference in the smoker group (P<0.05). Three months mortality rate was estimated at 23.1% in smokers with PCI and 7.1% in patients treated with thrombolytic therapy. Conclusion: Thrombolytic therapy can increase the EF of smoking patients with STEMI for a long time, indicating a beneficial effect of thrombolytic therapy to prevent heart failure.