In-hospital mortality of habitual cigarette smokers after acute myocardial infarction. The ‘smoker’s paradox' in a countrywide study

Aims Habitual cigarette smokers, paradoxically, present improved short-term prognosis after acute myocardial infarction, a phenomenon often termed ‘smoker’s paradox'. We sought to examine cigarette smokers' post-infarction survival advantage in a countrywide survey of unselected, consecuti...

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Published in:European heart journal 2001-05, Vol.22 (9), p.776-784
Main Authors: Andrikopoulos, G.K, Richter, D.J, Dilaveris, P.E, Pipilis, A, Zaharoulis, A, Gialafos, J.E, Toutouzas, P.K, Chimonas, E.T
Format: Article
Language:English
Subjects:
Acute myocardial infarction
Aged
Analysis of Variance
Biological and medical sciences
Cardiology. Vascular system
Chi-Square Distribution
cigarette smoking
Coronary heart disease
Female
Greece - epidemiology
Heart
Hospital Mortality
Humans
Logistic Models
Male
Medical sciences
Middle Aged
Myocardial Infarction - diagnosis
Myocardial Infarction - mortality
Myocardial Infarction - therapy
Prognosis
Smoking - adverse effects
Smoking - mortality
Thrombolytic Therapy
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container_end_page 784
container_issue 9
container_start_page 776
container_title European heart journal
container_volume 22
creator Andrikopoulos, G.K
Richter, D.J
Dilaveris, P.E
Pipilis, A
Zaharoulis, A
Gialafos, J.E
Toutouzas, P.K
Chimonas, E.T
description Aims Habitual cigarette smokers, paradoxically, present improved short-term prognosis after acute myocardial infarction, a phenomenon often termed ‘smoker’s paradox'. We sought to examine cigarette smokers' post-infarction survival advantage in a countrywide survey of unselected, consecutive patients presenting with acute myocardial infarction. Methods and Results The study population was derived from the registry of the Hellenic study of acute myocardial infarction, which recruited 7433 consecutive patients with acute myocardial infarction from 76, out of a total of 86, hospitals countrywide. Cigarette smokers presented with lower unadjusted mortality rates (7·4% vs 14·5%, P
doi_str_mv 10.1053/euhj.2000.2315
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The ‘smoker’s paradox' in a countrywide study</title><source>Oxford Journals Online</source><creator>Andrikopoulos, G.K ; Richter, D.J ; Dilaveris, P.E ; Pipilis, A ; Zaharoulis, A ; Gialafos, J.E ; Toutouzas, P.K ; Chimonas, E.T</creator><creatorcontrib>Andrikopoulos, G.K ; Richter, D.J ; Dilaveris, P.E ; Pipilis, A ; Zaharoulis, A ; Gialafos, J.E ; Toutouzas, P.K ; Chimonas, E.T</creatorcontrib><description>Aims Habitual cigarette smokers, paradoxically, present improved short-term prognosis after acute myocardial infarction, a phenomenon often termed ‘smoker’s paradox'. We sought to examine cigarette smokers' post-infarction survival advantage in a countrywide survey of unselected, consecutive patients presenting with acute myocardial infarction. Methods and Results The study population was derived from the registry of the Hellenic study of acute myocardial infarction, which recruited 7433 consecutive patients with acute myocardial infarction from 76, out of a total of 86, hospitals countrywide. Cigarette smokers presented with lower unadjusted mortality rates (7·4% vs 14·5%, P&lt;0·001), were younger, predominantly of male gender and were less likely to suffer from diabetes mellitus and arterial hypertension. When all univariate predictors of poor outcome were included as covariates in multivariate analysis, smoking status was not significantly associated with inhospital mortality (relative risk=1·12, 95% CI=0·86–1·44, P=0·399). The beneficial effect of thrombolytic therapy was independent of the smoking status in both univariate and multivariate analysis. Conclusion Unadjusted mortality rates are significantly lower in smokers, but age accounted for much of their seemingly improved outcome. When a number of additional clinical variables were taken into consideration, no significant influence of habitual smoking on early outcome following acute myocardial infarction was observed.</description><identifier>ISSN: 0195-668X</identifier><identifier>EISSN: 1522-9645</identifier><identifier>DOI: 10.1053/euhj.2000.2315</identifier><identifier>PMID: 11350110</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Acute myocardial infarction ; Aged ; Analysis of Variance ; Biological and medical sciences ; Cardiology. Vascular system ; Chi-Square Distribution ; cigarette smoking ; Coronary heart disease ; Female ; Greece - epidemiology ; Heart ; Hospital Mortality ; Humans ; Logistic Models ; Male ; Medical sciences ; Middle Aged ; Myocardial Infarction - diagnosis ; Myocardial Infarction - mortality ; Myocardial Infarction - therapy ; Prognosis ; Smoking - adverse effects ; Smoking - mortality ; Thrombolytic Therapy</subject><ispartof>European heart journal, 2001-05, Vol.22 (9), p.776-784</ispartof><rights>2001 INIST-CNRS</rights><rights>Copyright 2001 The European Society of Cardiology.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c463t-bbf60d8f0e0676289024d67a0937e7b67dec6315568555090d67dafc0d14cd3a3</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27903,27904</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=983848$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11350110$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Andrikopoulos, G.K</creatorcontrib><creatorcontrib>Richter, D.J</creatorcontrib><creatorcontrib>Dilaveris, P.E</creatorcontrib><creatorcontrib>Pipilis, A</creatorcontrib><creatorcontrib>Zaharoulis, A</creatorcontrib><creatorcontrib>Gialafos, J.E</creatorcontrib><creatorcontrib>Toutouzas, P.K</creatorcontrib><creatorcontrib>Chimonas, E.T</creatorcontrib><title>In-hospital mortality of habitual cigarette smokers after acute myocardial infarction. The ‘smoker’s paradox' in a countrywide study</title><title>European heart journal</title><addtitle>Eur Heart J</addtitle><description>Aims Habitual cigarette smokers, paradoxically, present improved short-term prognosis after acute myocardial infarction, a phenomenon often termed ‘smoker’s paradox'. We sought to examine cigarette smokers' post-infarction survival advantage in a countrywide survey of unselected, consecutive patients presenting with acute myocardial infarction. Methods and Results The study population was derived from the registry of the Hellenic study of acute myocardial infarction, which recruited 7433 consecutive patients with acute myocardial infarction from 76, out of a total of 86, hospitals countrywide. Cigarette smokers presented with lower unadjusted mortality rates (7·4% vs 14·5%, P&lt;0·001), were younger, predominantly of male gender and were less likely to suffer from diabetes mellitus and arterial hypertension. When all univariate predictors of poor outcome were included as covariates in multivariate analysis, smoking status was not significantly associated with inhospital mortality (relative risk=1·12, 95% CI=0·86–1·44, P=0·399). The beneficial effect of thrombolytic therapy was independent of the smoking status in both univariate and multivariate analysis. Conclusion Unadjusted mortality rates are significantly lower in smokers, but age accounted for much of their seemingly improved outcome. When a number of additional clinical variables were taken into consideration, no significant influence of habitual smoking on early outcome following acute myocardial infarction was observed.</description><subject>Acute myocardial infarction</subject><subject>Aged</subject><subject>Analysis of Variance</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Chi-Square Distribution</subject><subject>cigarette smoking</subject><subject>Coronary heart disease</subject><subject>Female</subject><subject>Greece - epidemiology</subject><subject>Heart</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - diagnosis</subject><subject>Myocardial Infarction - mortality</subject><subject>Myocardial Infarction - therapy</subject><subject>Prognosis</subject><subject>Smoking - adverse effects</subject><subject>Smoking - mortality</subject><subject>Thrombolytic Therapy</subject><issn>0195-668X</issn><issn>1522-9645</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><recordid>eNpF0M9u1DAQBnALgei2cOWILCHRU4Idx3ZyRBVlK8qfQ5FWXKyJ7bBuN_HWdkRz65FHgNfrk-DVrspppJnffIcPoVeUlJRw9s5O6-uyIoSUFaP8CVpQXlVFK2r-FC0IbXkhRLM6QscxXmfVCCqeoyNKGSeUkgX6fTEWax-3LsEGDz7k4dKMfY_X0Lk05a12PyHYlCyOg7-xIWLokw0Y9JR3w-w1BOMydGMPQSfnxxJfrS1-uP-z_3i4_xvxFgIYf3eaGQas_TSmMP9yJsemycwv0LMeNtG-PMwT9P38w9XZsrj8-vHi7P1loWvBUtF1vSCm6YklQoqqaUlVGyGBtExa2QlprBa5CS4azjlpST4a6DUxtNaGATtBb_e52-BvJxuTGlzUdrOB0fopKkmauq1llWG5hzr4GIPt1Ta4AcKsKFG77tWue7XrXu26zw-vD8lTN1jznx_KzuDNAUDUsOkDjNrFR9c2rKmbrIq9cjHZu8crhBslJJNcLVc_VP1peb6Sn7-pL-wfYhegHQ</recordid><startdate>20010501</startdate><enddate>20010501</enddate><creator>Andrikopoulos, G.K</creator><creator>Richter, D.J</creator><creator>Dilaveris, P.E</creator><creator>Pipilis, A</creator><creator>Zaharoulis, A</creator><creator>Gialafos, J.E</creator><creator>Toutouzas, P.K</creator><creator>Chimonas, E.T</creator><general>Oxford University Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20010501</creationdate><title>In-hospital mortality of habitual cigarette smokers after acute myocardial infarction. 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Vascular system</topic><topic>Chi-Square Distribution</topic><topic>cigarette smoking</topic><topic>Coronary heart disease</topic><topic>Female</topic><topic>Greece - epidemiology</topic><topic>Heart</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myocardial Infarction - diagnosis</topic><topic>Myocardial Infarction - mortality</topic><topic>Myocardial Infarction - therapy</topic><topic>Prognosis</topic><topic>Smoking - adverse effects</topic><topic>Smoking - mortality</topic><topic>Thrombolytic Therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Andrikopoulos, G.K</creatorcontrib><creatorcontrib>Richter, D.J</creatorcontrib><creatorcontrib>Dilaveris, P.E</creatorcontrib><creatorcontrib>Pipilis, A</creatorcontrib><creatorcontrib>Zaharoulis, A</creatorcontrib><creatorcontrib>Gialafos, J.E</creatorcontrib><creatorcontrib>Toutouzas, P.K</creatorcontrib><creatorcontrib>Chimonas, E.T</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European heart journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Andrikopoulos, G.K</au><au>Richter, D.J</au><au>Dilaveris, P.E</au><au>Pipilis, A</au><au>Zaharoulis, A</au><au>Gialafos, J.E</au><au>Toutouzas, P.K</au><au>Chimonas, E.T</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>In-hospital mortality of habitual cigarette smokers after acute myocardial infarction. 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Cigarette smokers presented with lower unadjusted mortality rates (7·4% vs 14·5%, P&lt;0·001), were younger, predominantly of male gender and were less likely to suffer from diabetes mellitus and arterial hypertension. When all univariate predictors of poor outcome were included as covariates in multivariate analysis, smoking status was not significantly associated with inhospital mortality (relative risk=1·12, 95% CI=0·86–1·44, P=0·399). The beneficial effect of thrombolytic therapy was independent of the smoking status in both univariate and multivariate analysis. Conclusion Unadjusted mortality rates are significantly lower in smokers, but age accounted for much of their seemingly improved outcome. When a number of additional clinical variables were taken into consideration, no significant influence of habitual smoking on early outcome following acute myocardial infarction was observed.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>11350110</pmid><doi>10.1053/euhj.2000.2315</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record>
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ispartof European heart journal, 2001-05, Vol.22 (9), p.776-784
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source Oxford Journals Online
subjects Acute myocardial infarction
Aged
Analysis of Variance
Biological and medical sciences
Cardiology. Vascular system
Chi-Square Distribution
cigarette smoking
Coronary heart disease
Female
Greece - epidemiology
Heart
Hospital Mortality
Humans
Logistic Models
Male
Medical sciences
Middle Aged
Myocardial Infarction - diagnosis
Myocardial Infarction - mortality
Myocardial Infarction - therapy
Prognosis
Smoking - adverse effects
Smoking - mortality
Thrombolytic Therapy
title In-hospital mortality of habitual cigarette smokers after acute myocardial infarction. The ‘smoker’s paradox' in a countrywide study
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