In Hospital Outcome Among Smoker and Nonsmoker Patients Presented with ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Abstract

Objective: To determine the association between smoking and in-hospital outcomes in patients presented with ST-Elevation Myocardial Infarction undergoing primary percutaneous coronary intervention (PCI).

Methodology: This prospective cohort study was conducted at Department of Cardiology, National Institute of Cardiovascular Disease (NICVD), Karachi, from November 9, 2020 to May 8, 2021. All the patients (current smoker, ex-smoker and non-smoker) with age 18 years to 85 years, both gender, patients diagnosed with STEMI in accordance with operational definition and underwent primary PCI were included. Patients diagnosed with ST-Elevation Myocardial Infarction were divided into two groups, expose (smoker) and unexposed (nonsmoker). Before PPCI demographic detail were noted and body mass index was calculated after management of STEMI then PCI was performed. In hospital outcome i.e. heart failure, in-hospital mortality and transient ischemic attack were assessed within 30 days of hospital stay after PCI. All the collected data were entered into the proforma.

Results: Mean ±SD of age in exposed group was 56.5±11.8 and non-exposed group was 57.7±12.1 years. In group wise distribution of gender, 82 (70.7%) males and 34 (29.3%) females were enrolled in exposed group and 80 (68.9%) males and 36 (31.1%) females were included in non-exposed group. Risk of heart failure and transient ischemic attack were 1.4 and 5.0 times more likely in exposed as compared to unexposed with [Relative Risk 1.444 and 5.0 respectively. While risk of mortality was 0.2 times less likely in exposed as compared to unexposed with [Relative Risk 0.222] and P value was found to be as significant i.e. (P=0.030).

Conclusion: It is to be concluded that significant risk of heart failure and transient ischemic attack were noted in exposed as compared to unexposed and vice versa in case of mortality, but we cannot rule out residual confounders.