Why the study?
Data comparing 2-year major clinical outcomes between STEMI and NSTEMI in current smokers undergoing successful PCI with newer-generation DES are limited.
Does STEMI presentation compared to NSTEMI presentation affect major clinical outcomes in current smokers undergoing PCI with newer-generation DES?
Does STEMI presentation compared to NSTEMI presentation affect major clinical outcomes in current smokers undergoing PCI with newer-generation DES?
In current smokers undergoing PCI with newer-generation DES, clinical outcomes at 2 years are similar between those presenting with STEMI versus NSTEMI.
Similar 2-year outcomes in smoker AMI subgroups warrant no practice change; leaves open whether smoking equalizes STEMI/NSTEMI risk post new-generation DES.
We compared the 2-year major clinical outcomes between ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) in patients who are current smokers who underwent successful percutaneous coronary intervention (PCI) with newer-generation drug-eluting stents (DESs). The availability of data in this regard is limited.A total of 8357 AMI patients were included and divided into 2 groups: the STEMI group (n = 5124) and NSTEMI group (n = 3233). The primary endpoint was the occurrence of major adverse cardiac events (MACE), defined as all-cause death, recurrent myocardial infarction (re-MI), or coronary repeat revascularization. The secondary endpoints were the cumulative incidences of the individual components of MACE and stent thrombosis (definite or probable).After propensity score-matched (PSM) analysis, 2 PSM groups (2250 pairs, C-statistics = 0.795) were generated. In the PSM patients, both for 1 month and at 2 years, the cumulative incidence of MACE (P = .183 and P = .655, respectively), all-cause death, cardiac death, re-MI, all-cause death or MI, any repeat revascularization, and stent thrombosis (P = .998 and P = .341, respectively) was not significantly different between the STEMI and NSTEMI groups. In addition, these results were confirmed using multivariate analysis.In the era of contemporary newer-generation DESs, both during 1 month and at 2 years after index PCI, the major clinical outcomes were not significantly different between the STEMI and NSTEMI groups confined to the patients who are current smokers. However, further research is needed to confirm these results.
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A 2021 study studied this question.
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