Current Smoking and Prognosis After Acute ST-Segment Elevation Myocardial Infarction: New Pathophysiological Insights

JACC. Cardiovascular Imaging
Caroline HaigColin Berry

Abstract

The aim of this study was to mechanistically investigate associations among cigarette smoking, microvascular pathology, and longer term health outcomes in patients with acute ST-segment elevation myocardial infarction (MI). The pathophysiology of myocardial reperfusion injury and prognosis in smokers with acute ST-segment elevation MI is incompletely understood. Patients were prospectively enrolled during emergency percutaneous coronary intervention. Microvascular function in the culprit artery was measured invasively. Contrast-enhanced magnetic resonance imaging (1.5-T) was performed 2 days and 6 months post-MI. Infarct size and microvascular obstruction were assessed using late gadolinium enhancement imaging. Myocardial hemorrhage was assessed with T2* mapping. Pre-specified endpoints included: 1) all-cause death or first heart failure hospitalization; and 2) cardiac death, nonfatal MI, or urgent coronary revascularization (major adverse cardiovascular events). Binary logistic regression (odds ratio [OR] with 95% confidence interval [CI]) with smoking status was used. In total, 324 patients with ST-segment elevation MI were enrolled (mean age 59 years, 73% men, 60% current smokers). Current smokers were younger (age 55 ± 11 y...Continue Reading

Citations

Jun 25, 2019·Nicotine & Tobacco Research : Official Journal of the Society for Research on Nicotine and Tobacco·Ivan Berlin, Serena Tonstad
Nov 12, 2019·Cardiovascular Research·Lara S F KonijnenbergNiels van Royen
May 13, 2020·Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance·G J H SnelN H J Prakken
Jun 21, 2019·Nicotine & Tobacco Research : Official Journal of the Society for Research on Nicotine and Tobacco·Peng ZhangYi Yang
Feb 25, 2021·Current Cardiology Reports·Daniel J DohertyColin Berry
Apr 18, 2020·Journal of the American College of Cardiology·Björn RedforsGregg W Stone
Jun 3, 2021·International Journal of Environmental Research and Public Health·Hsiu-Ju HuangTsung-Cheng Hsieh
Sep 4, 2021·The International Journal of Cardiovascular Imaging·Ivan LechnerSebastian Johannes Reinstadler

❮ Previous
Next ❯

Clinical Trials Mentioned

NCT02072850

Software Mentioned

SAS
R

Related Concepts

Related Feeds

Cardiac Remodeling

Cardiac remodeling in response to a myocardial infarction is characterized by progressive ventricular dilatation, cardiac hypertrophy, fibrosis, and deterioration of cardiac performance. Discover the latest research on Cardiac Remodeling here.

Cardiomyopathy

Cardiomyopathy is a disease of the heart muscle, that can lead to muscular or electrical dysfunction of the heart. It is often an irreversible disease that is associated with a poor prognosis. There are different causes and classifications of cardiomyopathies. Here are the latest discoveries pertaining to this disease.