title: Smoking and infarct size among STEMI patients undergoing primary angioplasty.
abstract: BACKGROUND
  Prior studies have found that smokers with STEMI have lower mortality rates and a more favorable response to fibrinolytic therapy than nonsmokers, phenomenon defined as "the smoker's paradox". Still poorly explored is the impact of cigarette smoking in patients undergoing primary percutaneous coronary intervention. Aim of the current study was to evaluate the impact of cigarette smoking on scintigraphic infarct size in STEMI patients undergoing primary PCI.
  
  
  METHODS
  Our population is represented by 830 STEMI patients undergoing primary PCI. Infarct size was evaluated at 30 days by technetium-99m-sestamibi.
  
  
  RESULTS
  Smoking was associated with younger age (p < 0.001), a lower prevalence of female gender (p < 0.001), hypertension (p < 0.001), diabetes (p = 0.003), shorter ischemia time (p = 0.037), but higher rates of previous PCI (p = 0.016). No differences were observed in other clinical or angiographic characteristics. In particular, smoking did not affect the rate of postprocedural TIMI 3 flow. As shown in Fig. 1, smoking did not affect infarct size (12.5% [3.3%-23.7%] vs 12.7% [4.9%-25.9%], p = 0.12). Similar results were observed in subanalyses according to infarct location (anterior STEMI, p int = 0.33), gender (p int = 0.95) age, (p Int = 0.96), diabetes (p int = 0.85). The absence of any impact of smoking on infarct size was confirmed after correction for baseline characteristics, such as age, gender, hypertension, diabetes, previous PCI, ischemia time (OR [95% CI] = 0.80 [0.59-1.09], p = 0.15).
  
  
  CONCLUSIONS
  This study shows that among STEMI patients undergoing primary PCI smoking status does not affect infarct size.
authors: Division of Cardiology, "Maggiore della Carità" Hospital, Eastern Piedmont University, Novara, Italy. Electronic address: giuseppe.deluca@maggioreosp.novara.it.
authors: Giuseppe
authors: G
authors: De Luca
authors: Division of Cardiology Careggi Hospital, Florence, Italy.
authors: Guido
authors: G
authors: Parodi
authors: Nuclear Medicine Unity, University of Florence, Florence, Italy.
authors: Roberto
authors: R
authors: Sciagrà
authors: Division of Cardiology Careggi Hospital, Florence, Italy.
authors: Benedetta
authors: B
authors: Bellandi
authors: Division of Cardiology Careggi Hospital, Florence, Italy.
authors: Vincenzo
authors: V
authors: Comito
authors: Division of Cardiology Careggi Hospital, Florence, Italy.
authors: Ruben
authors: R
authors: Vergara
authors: Division of Cardiology Careggi Hospital, Florence, Italy.
authors: Angela
authors: A
authors: Migliorini
authors: Division of Cardiology Careggi Hospital, Florence, Italy.
authors: Renato
authors: R
authors: Valenti
authors: Division of Cardiology Careggi Hospital, Florence, Italy.
authors: David
authors: D
authors: Antoniucci
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D062645:Percutaneous Coronary Intervention; D011446:Prospective Studies; D011877:Radionuclide Imaging; D012907:Smoking / Q000009:adverse effects*; D017256:Technetium Tc 99m Sestamibi
chemical_list: D017256:Technetium Tc 99m Sestamibi
keywords: Infarct size; Primary angioplasty; STEMI; Smoking