Smoking status and in-hospital outcomes of ST elevation myocardial infarction patients in a Brazilian public university hospital

Abstract

Background: Prior studies have found that smokers with ST-segment elevation myocardial infarction (STEMI) are younger, have fewer coexisting high-features and lower mortality than nonsmokers.

Objectives: To evaluate the relationship between cigarette smoking status and in-hospital outcomes of patients treated with STEMI at a tertiary hospital.

Methods: Prospective cohort study of a single center. Patients admitted with STEMI between September 2016 and September 2019 were included. Smoking status was categorized as never-smokers, current smokers and former smokers. Clinical characteristics, length of stay, all-cause mortality and major cardiovascular events (MACE, defined as the composite of total mortality, re-infarction, stroke and cardiac arrest) during the in-hospital period were evaluated. Chi-square test, ANOVA and Tukey test, and the Kruskal-Wallis H test were used, as appropriate. P<.05 was considered statistically significant.

Results: Of the 230 patients hospitalized with STEMI in the period, 92 (40%) were currently smoking and 63 (27.3%) were former smokers. Current smokers (57.2±11.4 years) were younger than never-smokers (63.7±11.4 years) (p = 0.001) and former smokers (64.8±9.6 years) (p<0.001). Baseline characteristics and use of reperfusion therapy were unrelated to smoking status. Never-smokers, current smokers and former smokers had similar median length of stay, in-hospital mortality (6.8% vs. 9.9% vs. 11.3%, respectively, p=0.65) and MACE (p=0.41).

Conclusion: Compared to never-smokers and former smokers, current smoking is associated with the occurrence of STEMI at a younger age and with similar in-hospital mortality.