Current smokers with acute myocardial infarction had a significantly higher incidence of BMIPP/201Tl mismatch compared to nonsmokers (53% vs 31%, p=0.047), indicating more salvageable myocardium.
Observational (n=103)
Blinded observers
No
Does current smoking affect the extent of salvageable myocardium in patients with conservatively treated acute myocardial infarction?
Current smokers with conservatively treated AMI have a higher likelihood of salvageable myocardium compared to nonsmokers, providing a potential mechanistic explanation for the 'smoker's paradox'.
Absolute Event Rate: 53% vs 31%
p-value: p=0.047
Many reports have demonstrated that smokers who have suffered an acute myocardial infarction (AMI) have a better prognosis than nonsmokers. The present study investigated the effects of current smoking on myocardial injury with resting 123I-15-iodophenyl 3-methyl pentadecanoic acid (BMIPP)/201Tl myocardial single photon emission computed tomography in 103 patients with conservatively treated AMI. The left ventricular myocardium was divided into 9 segments and BMIPP and 201Tl defects were scored using a 5-point grading system (0 = normal and 4 = no uptake). The sum of the defect scores was defined as the total defect score. There was no significant difference in either the baseline severity of the coronary artery disease or the total defect scores for BMIPP and 201Tl between the current smoker and nonsmoker groups. The difference between the total defect scores for BMIPP and 201Tl tended to be larger in the current smoker group than in the nonsmoker group (2.0 +/- 1.9 vs 1.3 +/- 1.6, p = 0.056). Forty-one (53%) of 77 patients in the current smoker group exhibited a BMIPP/201Tl mismatch, whereas only 8 (31%) of 26 patients in the nonsmoker group did (p = 0.047). In conclusion, current smokers had more likelihood of salvageable myocardium in areas at risk, as demonstrated by BMIPP/201Tl mismatch, in AMI than nonsmokers.
Yamagishi et al. (Mon,) conducted a observational in Acute Myocardial Infarction (n=103). Current smoking vs. Nonsmokers was evaluated on BMIPP/201Tl mismatch (indicating salvageable myocardium) (p=0.047). Current smokers with acute myocardial infarction had a significantly higher incidence of BMIPP/201Tl mismatch compared to nonsmokers (53% vs 31%, p=0.047), indicating more salvageable myocardium.