TITLE:
Impact of Smoking Status on Hospital Outcome of Patients with ST-Segment Elevation Myocardial Infarction Either Treated by Pharmaco-Invasive Strategy or Primary Percutaneous Coronary Intervention
AUTHORS:
Ahmed F. Alaarag, Mahmoud A. Abouomar, Timoor M. Hassan
KEYWORDS:
Smoker Paradox, STEMI, Primary PCI, Pharmaco-Invasive Strategy
JOURNAL NAME:
World Journal of Cardiovascular Diseases,
Vol.10 No.6,
June
15,
2020
ABSTRACT: Introduction: Smoking is a common public problem with a high health burden. Many studies have shown that there are many hazardous actions of smoking on body systems especially haemostatic, respiratory and circulatory systems. Smoking may increase the thrombus burden in patients with acute coronary syndrome. The “smoker’s paradox” has been described for morethan 25 years. Its existence and its effect on patients’ outcomepost-myocardial infarction are debatable. Methods: Our prospective observational study was conducted from-August 2018 to August 2019 on STEMI patients with the duration from onset of symptoms to first medical contact were 12 hours or less. We included 199 patients in our study. Patients are divided into 4 groups Group 1 (Smokers treated by PPCI) Group 2 (Non-smokers treated by PPCI) Group 3 (Smoker treated by pharmaco-invasive strategy)Group 4 (Non- smoker treated by pharmaco-invasive strategy) TIMI flow before and afterPCI, duration of hospital stay and all caeses of MACE were assessed in each patient. Results: Smokers are younger than non-smokers and have fewer co-mor- bidities. Patients treatedby primary PCI and pharmaco-invasive strategy either smokers ornon-smokers showed no significant difference in angiographic data and outcome except that smokers treated by pharmaco-invasive strategy had a lower incidence of TIMI flow III at diagnostic angiography before PCI with P value (0.047). Conclusion: There is no actual smokers paradox. A pharmaco-invasive strategy is a good option when a PPCI is notavailable. Finally, early transfer of smokers treated with a pharmaco-invasivestrategy to a PCI capable hospital for early intervention may be recommended.