title: [Effects of smoke on clinical prognosis of patients with acute ST-segment elevation myocardial infarction].
abstract: OBJECTIVE
  To explore the effects of smoke on the clinical prognosis of patients with acute ST-segment elevation myocardial infarction (ASTEMI).
  
  
  METHODS
  A total of 1213 consecutive ASTEMI patients were admitted into 20 hospitals in Liaoning province between May 2009 and May 2010. They were stratified into smoke (n = 588) and non-smoke (n = 625) groups. Basic demographic profiles, treatment data and clinical outcomes were compared between two groups. The primary endpoint was cardiac death and the secondary endpoints included non-fatal myocardial infarction, stroke and revascularization. Cox proportional hazard analyses were performed.
  
  
  RESULTS
  The proportion of percutaneous coronary intervention (PCI) in the smoke group was significantly higher than that in the non-smoke group (40.8% vs 22.1%, P < 0.001). During the follow-up period, the medication rate was significantly higher in the smoke group than that in the non-smoke group (aspirin: 75.3% vs 62.2%, P < 0.001; clopidogrel: 40.5% vs 32.2%, P = 0.003; β receptor blockade: 45.4% vs 36.0%, P = 0.001; angiotensin-converting-enzyme inhibitor/angiotensin II receptor blocker (ACEI/ARB): 38.3% vs 32.2%, P = 0.026; statins: 57.3% vs 44.2%, P < 0.001). During the follow-up period, the rate of cardiac death was lower in the smoke group than that in the non-smoke group (10.2% vs 24.2%, P < 0.001). No significant differences existed between two groups. During the follow-up period, the rate of cardiac death was significantly correlated with smoke (HR 2.777, 95%CI 1.113 - 6.928, P = 0.029), PCI (HR 0.208, 95%CI 0.062 - 0.700, P = 0.011), age (HR 1.049, 95%CI 1.005 - 1.095, P = 0.028), aspirin (HR 0.165, 95%CI 0.061 - 0.446, P < 0.001) and statins (HR 0.382, 95%CI 0.317 - 0.462, P < 0.001).
  
  
  CONCLUSIONS
  Among the ASTEMI patients, the rate of cardiac death is significantly lower in the smoke group than that in the non-smoke group. And it is significantly correlated with such independent risk factors as smoke, PCI, age, aspirin and statins.
authors.affiliation: Department of Cardiology, First Affiliated Hospital, China Medical University, Shenyang, China.
authors.forename: Yu-jiao
authors.initials: YJ
authors.lastname: Sun
authors.forename: Yu-ze
authors.initials: YZ
authors.lastname: Li
authors.forename: Da-ming
authors.initials: DM
authors.lastname: Jiang
authors.forename: Bo
authors.initials: B
authors.lastname: Zhang
authors.forename: Yuan
authors.initials: Y
authors.lastname: Gao
authors.forename: Hai-jie
authors.initials: HJ
authors.lastname: Yu
authors.forename: Guo-xian
authors.initials: GX
authors.lastname: Qi
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012906:Smoke / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D012906:Smoke