Clinical characteristics and prognosis of acute myocardial infarction in young smokers and non-smokers (≤ 45 years): a systematic review and meta-analysis

// Yuqi Liu 1, * , Tianwen Han 1, * , Ming Gao 2, * , Jinwen Wang 3 , Fang Liu 3 , Shanshan Zhou 1 and Yundai Chen 1 1 Department of Cardiology, PLA General Hospital, Beijing 100853, China 2 ICU of The First Phase Beijing Tsinghua Changgeng Hospital, Beijing 100044, China 3 Department of Cardiology of Anzhen Hospital, Beijing 100029, China * These authors contributed equally to this work Correspondence to: Yundai Chen, email: cyundai@vip.163.com Keywords: young, AMI, smoking, prognosis, meta-analysis Received: June 04, 2017      Accepted: September 04, 2017      Published: September 20, 2017 ABSTRACT The effect of smoking on the prognosis of young patients with acute myocardial infarction (AMI) is inconclusive. We enrolled 2188 young AMI patients (≤ 45 years) from the cardiac center of the Chinese PLA General Hospital and Anzhen Hospital and analyzed their clinical characteristics and prognosis. We also searched the PubMed, EMBASE, and Cochrane Central Register of Controlled Trials electronic databases for January 2001 to March 2017 and considered for inclusion in a meta-analysis those clinical trials that compared prognoses of young smokers and non-smokers with AMI. The proportion of males and alcohol users was higher in young AMI smokers than in non-smokers; the proportion of hypertension was slightly lower. There was no difference in medical treatment between smokers and non-smokers. No differences were evident between smokers and non-smokers regarding in-hospital cardiac events and major adverse cardiovascular events on follow-up, including incidence of stroke. For young AMI patients, smoking did not lead to poorer prognosisin comparison with not smoking. This “smoker’s paradox” needs to be confirmed by more randomized controlled multicenter prospective clinical trials.