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The Smoker's Paradox in Acute Coronary Syndrome: Is It Real?

2018Journal article Open access
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dc.contributor.authorCoutinho Cruz, M
dc.contributor.authorIlhão Moreira, R
dc.contributor.authorAbreu, A
dc.contributor.authorTimóteo, AT
dc.contributor.authorSá Carvalho, R
dc.contributor.authorFerreira, L
dc.contributor.authorCruz Ferreira, R
dc.date.accessioned2020-02-05T16:21:23Z
dc.date.available2020-02-05T16:21:23Z
dc.date.issued2018
dc.description.abstractINTRODUCTION: Smoking is associated with atherosclerotic disease, but there is controversy about its protective nature after acute coronary syndrome (ACS). OBJECTIVE: To determine the impact of smoking on the presentation, treatment and outcome of ACS. METHODS: We analyzed all consecutive patients with ACS in a single center between 2005 and 2014. Current smokers and never-smokers were compared. Independent predictors of in-hospital mortality and of a composite of all-cause mortality, rehospitalization for cardiovascular causes, angiography, percutaneous coronary intervention and coronary artery bypass grafting were assessed by multivariate logistic regression. RESULTS: A total of 2727 patients were included, 41.7% current smokers and 58.3% never-smokers. Current smokers were younger, more often male, had fewer comorbidities, a typical clinical presentation, lower heart rate, systolic blood pressure, Killip class, BNP/NT-pro-BNP and creatinine, better left ventricular systolic function and less severe coronary anatomy. ST-segment elevation myocardial infarction was more common in current smokers. Current smokers received more evidence-based treatments and had less in-hospital complications, in-hospital mortality and adverse outcomes at one year. More frequent percutaneous coronary intervention at one year was noted in current smokers. Smoking was not an independent predictor of outcome when the multivariate model was fully adjusted for baseline characteristics. CONCLUSION: The smoker's paradox was not observed in this population, since all differences in outcome were explained by smokers' more benign baseline characteristics.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationRev Port Cardiol. 2018 Oct;37(10):847-855.pt_PT
dc.identifier.doi10.1016/j.repc.2017.12.005pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3410
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherElsevierpt_PT
dc.subjectAdultpt_PT
dc.subjectAgedpt_PT
dc.subjectAged, 80 and overpt_PT
dc.subjectFemalept_PT
dc.subjectHumanspt_PT
dc.subjectMalept_PT
dc.subjectMiddle Agedpt_PT
dc.subjectMyocardial Infarctionpt_PT
dc.subjectRisk Factorspt_PT
dc.subjectSmokerspt_PT
dc.subjectSmokingpt_PT
dc.subjectTreatment Outcomept_PT
dc.subjectAcute Coronary Syndromept_PT
dc.subjectHSM CARpt_PT
dc.titleThe Smoker's Paradox in Acute Coronary Syndrome: Is It Real?pt_PT
dc.title.alternativeO Paradoxo dos Fumadores nas Síndromes Coronárias Agudas: Será Real?pt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage855pt_PT
oaire.citation.issue10pt_PT
oaire.citation.startPage847pt_PT
oaire.citation.titleRevista Portuguesa de Cardiologiapt_PT
oaire.citation.volume37pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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