Cigarette Smoking is Paradoxically Associated With Low Mortality Risk After Acute Myocardial Infarction

Title
Cigarette Smoking is Paradoxically Associated With Low Mortality Risk After Acute Myocardial Infarction
Author(s)
김영조최동주[최동주]강시혁[강시혁]차인호[차인호]조구용[조구용]김주한[김주한]정명호[정명호]안영균[안영균]조명찬[조명찬]
Keywords
RECEIVING THROMBOLYTIC THERAPY; PROPENSITY SCORE; CLOPIDOGREL; PROGNOSIS; TOBACCO; TRIAL
Issue Date
201307
Publisher
OXFORD UNIV PRESS
Citation
NICOTINE & TOBACCO RESEARCH, v.15, no.7, pp.1230 - 1238
Abstract
Cigarette smoking has been shown to be associated with a decreased risk of death after acute myocardial infarction (AMI), which is also known as the smokers paradox. This study aimed to investigate the relationship between smoking and all-cause mortality after AMI. We extracted the data of patients who were hospitalized for AMI between November 2005 and September 2010 from nationwide multicenter prospective registries in Korea. Among a total of 29,199 patients with AMI, 10,251 (42.3%) were current smokers, and 14,006 (57.7%) were nonsmokers. Current smokers were younger, more likely to be male, and had lower frequencies of hypertension, diabetes mellitus, dyslipidemia, and previous history of ischemic heart disease than nonsmokers. The initial presentation was less severe in terms of hemodynamic status, and angiography showed less complex coronary involvement in smokers. The overall mortality rate was 5.4% for current smokers and 9.9% for nonsmokers (hazard ratio [HR], 0.52; 95% confidence interval [CI], 0.470.58; p < .001). The gap in risk was attenuated after multivariable adjustment but remained statistically significant (HR, 0.85; 95% CI, 0.760.95; p .005). Propensity score matching corroborated the results of reduced mortality among current smokers (6.7% vs. 7.6%; p .005). In this study, in which the patients received up-to-date treatment options, smoking was associated with a 48% decrease in the risk of all-cause mortality at 1 year after AMI.
URI
http://hdl.handle.net/YU.REPOSITORY/29359http://dx.doi.org/10.1093/ntr/nts248
ISSN
1462-2203
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의과대학 > 내과학교실 > Articles
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