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Impact of Smoking Status on Mortality in STEMI Patients Undergoing Mechanical Reperfusion for STEMI: Insights from the ISACS–STEMI COVID-19 Registry

2022; Multidisciplinary Digital Publishing Institute; Volume: 11; Issue: 22 Linguagem: Inglês

10.3390/jcm11226722

2077-0383

Giuseppe De Luca, Magdy Algowhary, Berat Uğuz, Dinaldo Cavalcanti de Oliveira, V. I. Ganyukov, Zan Zimbakov, Miha Čerček, Lisette Okkels Jensen, Poay Huan Loh, Lucian Câlmâc, Gerard Roura Ferrer, Alexandre Schaan de Quadros, Marek Milewski, Fortunato Scotto D’Uccio, Clemens von Birgelen, Francesco Versaci, Jurriën M. ten Berg, Gianni Casella, Aaron Wong Sung Lung, Petr Kala, José Luis Díez Gil, Xavier Carrillo, Maurits T. Dirksen, Víctor Manuel Becerra‐Muñoz, Michael Lee, Dafsah Arifa Juzar, Rodrigo de Moura Joaquim, Roberto Paladino, Davor Miličić, Periklis Davlouros, Nikola Bakraceski, Filippo Zilio, Luca Donazzan, Adriaan O. Kraaijeveld, Gennaro Galasso, Árpád Lux, Lucia Marinucci, Vincenzo Guiducci, Maurizio Menichelli, Alessandra Scoccia, Aylin Hatice Yamaç, Kadir Uğur Mert, Xacobe Flores‐Ríos, Tomáš Kovárník, Michał Kidawa, José Moreu, Flavien Vincent, Enrico Fabris, Íñigo Lozano, Marco Boccalatte, Francisco Bosa Ojeda, Carlos Arellano Serrano, Gianluca Caiazzo, Giuseppe Cirrincione, Hsien‐Li Kao, Juan Sanchís, Luigi Vignali, Hélder Pereira, Stéphane Manzo‐Silberman, Santiago Ordóñez, Alev Arat Özkan, Bruno Scheller, Heidi Lehtola, Rui Campante Teles, Christos Mantis, Ylitalo Antti, João Silveira, Rodrigo Zoni, И. С. Бессонов, Stefano Savonitto, George Kochiadakis, Dimitrios Alexopulos, C. Uribe, John Kanakakis, Benjamin Faurie, Gabriele Gabrielli, Alejandro Gutiérrez, Juan Pablo Bachini, Alex Rocha, Frankie C.C. Tam, Alfredo Rodriguez, Antonia Anna Lukito, Veauthyelau Saint-Joy, Gustavo Pessah, Andrea Tuccillo, Giuliana Cortese, Guido Parodi, Mohamed Abed Bouraghda, Elvin Kedhi, Pablo Lamelas, Harry Suryapranata, Matteo Nardin, Monica Verdoia,

COVID-19 and healthcare impacts

The so-called “smoking paradox”, conditioning lower mortality in smokers among STEMI patients, has seldom been addressed in the settings of modern primary PCI protocols. The ISACS−STEMI COVID-19 is a large-scale retrospective multicenter registry addressing in-hospital mortality, reperfusion, and 30-day mortality among primary PCI patients in the era of the COVID-19 pandemic. Among the 16,083 STEMI patients, 6819 (42.3%) patients were active smokers, 2099 (13.1%) previous smokers, and 7165 (44.6%) non-smokers. Despite the impaired preprocedural recanalization (p < 0.001), active smokers had a significantly better postprocedural TIMI flow compared with non-smokers (p < 0.001); this was confirmed after adjustment for all baseline and procedural confounders, and the propensity score. Active smokers had a significantly lower in-hospital (p < 0.001) and 30-day (p < 0.001) mortality compared with non-smokers and previous smokers; this was confirmed after adjustment for all baseline and procedural confounders, and the propensity score. In conclusion, in our population, active smoking was significantly associated with improved epicardial recanalization and lower in-hospital and 30-day mortality compared with previous and non-smoking history.