Association of smoking with myocardial injury and clinical outcome in patients undergoing mechanical reperfusion for ST-elevation myocardial infarction
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Why the study?
Does smoking status improve myocardial salvage or clinical outcomes in STEMI patients undergoing primary PCI?
Population
727 consecutive patients with ST-elevation myocardial infarction reperfused within 12 hours after symptom…
Comparison
Current smoking at admission (n=339, 46.6%) vs Non-smokers at admission
Design
Cohort
Follow-up
12 months
Authors
Discussion
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Member takes
Implication
Challenges smoker's paradox on CMR salvage; leaves open whether observational associations reflect bias rather than reperfusion benefit.
Structured PICO
Does smoking status improve myocardial salvage or clinical outcomes in STEMI patients undergoing primary PCI?
P
Population
727 consecutive patients with ST-elevation myocardial infarction (STEMI) reperfused within 12 hours after symptom onset undergoing primary percutaneous coronary intervention (PPCI).
I
Intervention
Current smoking at admission (n=339, 46.6%)
C
Comparator
Non-smokers at admission
O
Outcome
Cardiac magnetic resonance (CMR)-determined myocardial salvage and damage (area-at-risk [AAR], infarct size [IS], myocardial salvage index [MSI], and microvascular obstruction [MVO]), and Major adverse cardiac events (MACE) at 12 monthscomposite
The apparent 'smoker's paradox' in STEMI patients undergoing primary PCI is entirely explained by baseline risk differences, with smoking showing no true protective effect on myocardial salvage or clinical outcomes.
Cite This Study
Eitel et al. (2016) studied this question.
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