Key result
Continued smoking was the most powerful predictor for the recurrence of cardiac events (OR 3.784) in young Chinese patients following a first ST-segment elevation myocardial infarction.
Observational (n=341)
No
Odds Ratio: 3.784 (95% CI 1.636–8.751)
p-value: p=<0.01
In young Chinese patients surviving a first STEMI, continued smoking is highly prevalent and serves as the strongest predictor for recurrent cardiac events.
Distinct risk profiles in young Chinese STEMI patients warrant tailored screening; leaves open applicability of Western prevention strategies.
BACKGROUND: The proportion of the mainland Chinese population with premature ST-segment elevation myocardial infarction is significantly elevated. Young patients with ST-segment elevation myocardial infarction have a different risk factor profile and clinical outcome compared with elder patients, and may also differ as compared to young patients in Western populations. METHODS: We analyzed a total of 9462 consecutive ST-segment elevation myocardial infarction patients, and recruited 341 consecutive cases who had survived their first ST-segment elevation myocardial infarction at the age less than 40 years, and followed-up these patients for 5 years. RESULTS: The most prevalent risk factor in young Chinese ST-segment elevation myocardial infarction patients was smoking (307/341, 90.03%) and male gender (328/341, 96.19%), although young patients had fewer traditional risk factors of acute myocardial infarction than the control group [(1.63 ± 1.03) vs. (2.38 ± 1.15), p < 0.01]. The number of affected vessels in cases was significantly less than in the elder control group (p < 0.01). During the follow-up, blood lipids and blood pressure of most patients reached the target level, while 42.10% of patients reported continuation of smoking. Multivariable data analysis showed that persistence of smoking (OR: 3.784, 95% CI: 1.636-8.751, p < 0.01) was the most significant prognostic factor of cardiac events after adjusting for various confounding factors. CONCLUSIONS: We demonstrated that cigarette smoking is the most prevalent factor among the avoidable cardiovascular risk factors for young ST-segment elevation myocardial infarctions in China. Accordingly, continued smoking is the most powerful predictor for the recurrence of cardiac events in young Chinese patients with ST-segment elevation myocardial infarction.
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Qian et al. (2015) conducted an observational in ST-segment elevation myocardial infarction (STEMI) (n=341). Persistence of smoking vs. Smoking cessation or non-smoking was evaluated on Recurrence of cardiac events (cardiac death, readmissions for acute coronary syndrome, and revascularization) (OR 3.784, 95% CI 1.636-8.751, p=<0.01). Continued smoking was the most powerful predictor for the recurrence of cardiac events (OR 3.784) in young Chinese patients following a first ST-segment elevation myocardial infarction.
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