PMID- 27931553
OWN - NLM
STAT- MEDLINE
DCOM- 20170524
LR  - 20181113
IS  - 2213-3763 (Electronic)
IS  - 0019-4832 (Print)
IS  - 0019-4832 (Linking)
VI  - 68
IP  - 6
DP  - 2016 Nov-Dec
TI  - Change in left ventricular systolic function in patients with ST elevation 
      myocardial infarction: Evidence for smoker's paradox or pseudo-paradox?
PG  - 816-820
LID - S0019-4832(16)30020-7 [pii]
LID - 10.1016/j.ihj.2016.04.001 [doi]
AB  - BACKGROUND: The 'smoker's paradox' refers to the observation of favorable 
      prognosis in current smokers following an acute ST elevation myocardial 
      infarction (STEMI) in the era of fibrinolysis, however, several STEMI studies 
      have demonstrated conflicting results in patients undergoing primary percutaneous 
      coronary intervention (p-PCI). OBJECTIVE: Aim of the current study was to 
      evaluate the impact of cigarette smoking on left ventricular function in STEMI 
      patients undergoing p-PCI. METHODS: Our population is represented by 74 
      first-time anterior STEMI patients undergoing p-PCI, 37 of whom were smokers. We 
      assessed left ventricular function by left ventricular ejection fraction (LVEF) 
      on the second day after admission and at 3-month follow-up. Early predictors of 
      adverse left ventricular remodelling after STEMI treated by p-PCI were examined. 
      RESULTS: Basal demographics and comorbidities were similar between groups. 
      Although the LVEF during the early phase was higher in smokers compared to 
      non-smokers (44.95+/-7.93% vs. 40.32+/-7.28%; p=0.011); it worsened in smokers at 
      follow-up (mean decrease in LVEF: -2.70+/-5.95%), whereas it improved in 
      non-smokers (mean recovery of LVEF: +2.97+/-8.45%). In univariate analysis, 
      diabetes mellitus, peak troponin I, current smoking, and lower TIMI flow grade 
      after p-PCI, pain-to-door time and door-to-balloon times were predictors of 
      adverse left ventricular remodelling. After multivariate logistic regression 
      analysis, smoking at admission, lower TIMI flow grade after p-PCI, the 
      pain-to-door time and door-to-balloon times remained independent predictors of 
      deterioration in LVEF. CONCLUSION: True or persistent 'smoker's paradox' does not 
      appear to be relevant among STEMI patients undergoing p-PCI. The 'smoker's 
      paradox' is in fact a pseudo-paradox. Further studies with larger numbers may be 
      warranted.
CI  - Copyright A(c) 2016 Cardiological Society of India. Published by Elsevier B.V. All 
      rights reserved.
FAU - Acar, Burak
AU  - Acar B
AD  - Turkiye Yuksek Ihtisas Training and Research Hospital, Department of Cardiology, 
      Ankara, Turkey.
FAU - Ozeke, Ozcan
AU  - Ozeke O
AD  - Turkiye Yuksek Ihtisas Training and Research Hospital, Department of Cardiology, 
      Ankara, Turkey. Electronic address: ozcanozeke@gmail.com.
FAU - Unal, Sefa
AU  - Unal S
AD  - Turkiye Yuksek Ihtisas Training and Research Hospital, Department of Cardiology, 
      Ankara, Turkey.
FAU - Karakurt, Mustafa
AU  - Karakurt M
AD  - Turkiye Yuksek Ihtisas Training and Research Hospital, Department of Cardiology, 
      Ankara, Turkey.
FAU - Kara, Meryem
AU  - Kara M
AD  - Turkiye Yuksek Ihtisas Training and Research Hospital, Department of Cardiology, 
      Ankara, Turkey.
FAU - Kirbas, Ozgur
AU  - Kirbas O
AD  - Turkiye Yuksek Ihtisas Training and Research Hospital, Department of Cardiology, 
      Ankara, Turkey.
FAU - Sen, Fatih
AU  - Sen F
AD  - Turkiye Yuksek Ihtisas Training and Research Hospital, Department of Cardiology, 
      Ankara, Turkey.
FAU - Korkmaz, Ahmet
AU  - Korkmaz A
AD  - Numune Training and Research Hospital, Department of Cardiology, Ankara, Turkey.
FAU - Aras, Dursun
AU  - Aras D
AD  - Turkiye Yuksek Ihtisas Training and Research Hospital, Department of Cardiology, 
      Ankara, Turkey.
FAU - Aydogdu, Sinan
AU  - Aydogdu S
AD  - Turkiye Yuksek Ihtisas Training and Research Hospital, Department of Cardiology, 
      Ankara, Turkey.
LA  - eng
PT  - Journal Article
DEP - 20160414
PL  - India
TA  - Indian Heart J
JT  - Indian heart journal
JID - 0374675
SB  - IM
MH  - Aged
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Percutaneous Coronary Intervention
MH  - Prognosis
MH  - ST Elevation Myocardial Infarction/etiology/*physiopathology/surgery
MH  - Smoking/*adverse effects
MH  - Stroke Volume/*physiology
MH  - Time Factors
MH  - Ventricular Function, Left/*physiology
MH  - Ventricular Remodeling/*physiology
PMC - PMC5143820
OTO - NOTNLM
OT  - Cigarette smoking
OT  - Primary percutaneous coronary intervention
OT  - ST elevation myocardial infarction
OT  - Smoker's paradox
EDAT- 2016/12/10 06:00
MHDA- 2017/05/26 06:00
PMCR- 2017/11/01
CRDT- 2016/12/10 06:00
PHST- 2016/02/05 00:00 [received]
PHST- 2016/03/23 00:00 [revised]
PHST- 2016/04/01 00:00 [accepted]
PHST- 2016/12/10 06:00 [entrez]
PHST- 2016/12/10 06:00 [pubmed]
PHST- 2017/05/26 06:00 [medline]
PHST- 2017/11/01 00:00 [pmc-release]
AID - S0019-4832(16)30020-7 [pii]
AID - 10.1016/j.ihj.2016.04.001 [doi]
PST - ppublish
SO  - Indian Heart J. 2016 Nov-Dec;68(6):816-820. doi: 10.1016/j.ihj.2016.04.001. Epub 
      2016 Apr 14.