SMOKING PARADOX IN HYPERTENSIVE ST SEGMENT ELEVATION MYOCARDIAL INFARCTION PATIENTS: 25-YEAR POPULATION-BASED STUDY

Abstract

Objective: The main objective of our paper is to study the effect of smoking status on the outcomes of hypertensive patients presenting with ST-segment elevation myocardial infraction. Design and method: Patients with STEMI who were hospitalised in our coronary care unit during a 25-year period (since 1994) were included in a specific registry. Their in-hospital and follow-up data have been regularly updated. We selected only patients with known or newly diagnosed hypertension in our study. Then, we divided the population into two groups according to their smoking status. The primary endpoints were death, rehospitalization, non-fatal myocardial infarction. The secondary endpoints were in-hospital mortality, left ventricular dysfunction, life-threatening arrythmias, prolonged hospital stay and bleeding complications. Results: A total of 1609 patients were included during the study period. Among 489 patients having hypertension, 45.5% were smokers with male sex predominance (sex ratio 11/1). Baseline characteristics are detailed in table 1. Among the primary endpoint: One-year mortality was significantly more important in the non-smokers group (p = 0.012): there was no significant difference in non-fatal MI (p = 0,142) and in all cause rehospitalization (p = 0.093). As for the secondary endpoints, there was no significant difference between the two groups except for the in-hospital death (p < 0.01). The results of the endpoints are detailed in table 1. Conclusions: Smoking seems to have a beneficial effect on the outcomes of STEMI of hypertensive patients.