Impact of Smoking Status on Mortality in STEMI Patients Undergoing Mechanical Reperfusion for STEMI: Insights from the ISACS-STEMI COVID-19 Registry

Giuseppe De Luca; Magdy Algowhary; Berat Uguz; Dinaldo C Oliveira; Vladimir Ganyukov; Zan Zimbakov; Miha Cercek; Lisette Okkels Jensen; Poay Huan Loh; Lucian Calmac; Gerard Roura I Ferrer; Alexandre Quadros; Marek Milewski; Fortunato Scotto D'Uccio; Clemens von Birgelen; Francesco Versaci; Jurrien Ten Berg; Gianni Casella; Aaron Wong Sung Lung; Petr Kala; José Luis Díez Gil; Xavier Carrillo; Maurits Dirksen; Victor M Becerra-Munoz; Michael Kang-Yin Lee; Dafsah Arifa Juzar; Rodrigo de Moura Joaquim; Roberto Paladino; Davor Milicic; Periklis Davlouros; Nikola Bakraceski; Filippo Zilio; Luca Donazzan; Adriaan Kraaijeveld; Gennaro Galasso; Lux Arpad; Marinucci Lucia; Guiducci Vincenzo; Maurizio Menichelli; Alessandra Scoccia; Aylin Hatice Yamac; Kadir Ugur Mert; Xacobe Flores Rios; Tomas Kovarnik; Michal Kidawa; Josè Moreu; Flavien Vincent; Enrico Fabris; Iñigo Lozano Martínez-Luengas; Marco Boccalatte; Francisco Bosa Ojeda; Carlos Arellano-Serrano; Gianluca Caiazzo; Giuseppe Cirrincione; Hsien-Li Kao; Juan Sanchis Forés; Luigi Vignali; Helder Pereira; Stephane Manzo; Santiago Ordoñez; Alev Arat Özkan; Bruno Scheller; Heidi Lehtola; Rui Teles; Christos Mantis; Ylitalo Antti; João António Brum Silveira; Rodrigo Zoni; Ivan Bessonov; Stefano Savonitto; George Kochiadakis; Dimitrios Alexopulos; Carlos E Uribe; John Kanakakis; Benjamin Faurie; Gabriele Gabrielli; Alejandro Gutierrez Barrios; Juan Pablo Bachini; Alex Rocha; Frankie Chor-Cheung Tam; Alfredo Rodriguez; Antonia Anna Lukito; Veauthyelau Saint-Joy; Gustavo Pessah; Andrea Tuccillo; Giuliana Cortese; Guido Parodi; Mohamed Abed Bouraghda; Elvin Kedhi; Pablo Lamelas; Harry Suryapranata; Matteo Nardin; Monica Verdoia

doi:10.3390/jcm11226722

Impact of Smoking Status on Mortality in STEMI Patients Undergoing Mechanical Reperfusion for STEMI: Insights from the ISACS-STEMI COVID-19 Registry

Giuseppe De Luca^*, Magdy Algowhary, Berat Uguz, Dinaldo C Oliveira, Vladimir Ganyukov, Zan Zimbakov, Miha Cercek, Lisette Okkels Jensen, Poay Huan Loh, Lucian Calmac, Gerard Roura I Ferrer, Alexandre Quadros, Marek Milewski, Fortunato Scotto D'Uccio, Clemens von Birgelen, Francesco Versaci, Jurrien Ten Berg, Gianni Casella, Aaron Wong Sung Lung, Petr KalaJosé Luis Díez Gil, Xavier Carrillo, Maurits Dirksen, Victor M Becerra-Munoz, Michael Kang-Yin Lee, Dafsah Arifa Juzar, Rodrigo de Moura Joaquim, Roberto Paladino, Davor Milicic, Periklis Davlouros, Nikola Bakraceski, Filippo Zilio, Luca Donazzan, Adriaan Kraaijeveld, Gennaro Galasso, Lux Arpad, Marinucci Lucia, Guiducci Vincenzo, Maurizio Menichelli, Alessandra Scoccia, Aylin Hatice Yamac, Kadir Ugur Mert, Xacobe Flores Rios, Tomas Kovarnik, Michal Kidawa, Josè Moreu, Flavien Vincent, Enrico Fabris, Iñigo Lozano Martínez-Luengas, Marco Boccalatte, Francisco Bosa Ojeda, Carlos Arellano-Serrano, Gianluca Caiazzo, Giuseppe Cirrincione, Hsien-Li Kao, Juan Sanchis Forés, Luigi Vignali, Helder Pereira, Stephane Manzo, Santiago Ordoñez, Alev Arat Özkan, Bruno Scheller, Heidi Lehtola, Rui Teles, Christos Mantis, Ylitalo Antti, João António Brum Silveira, Rodrigo Zoni, Ivan Bessonov, Stefano Savonitto, George Kochiadakis, Dimitrios Alexopulos, Carlos E Uribe, John Kanakakis, Benjamin Faurie, Gabriele Gabrielli, Alejandro Gutierrez Barrios, Juan Pablo Bachini, Alex Rocha, Frankie Chor-Cheung Tam, Alfredo Rodriguez, Antonia Anna Lukito, Veauthyelau Saint-Joy, Gustavo Pessah, Andrea Tuccillo, Giuliana Cortese, Guido Parodi, Mohamed Abed Bouraghda, Elvin Kedhi, Pablo Lamelas, Harry Suryapranata, Matteo Nardin, Monica Verdoia

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

The so-called "smoking paradox", conditioning lower mortality in smokers among STEMI patients, has seldom been addressed in the settings of modern primary PCI protocols. The ISACS-STEMI COVID-19 is a large-scale retrospective multicenter registry addressing in-hospital mortality, reperfusion, and 30-day mortality among primary PCI patients in the era of the COVID-19 pandemic. Among the 16,083 STEMI patients, 6819 (42.3%) patients were active smokers, 2099 (13.1%) previous smokers, and 7165 (44.6%) non-smokers. Despite the impaired preprocedural recanalization (p < 0.001), active smokers had a significantly better postprocedural TIMI flow compared with non-smokers (p < 0.001); this was confirmed after adjustment for all baseline and procedural confounders, and the propensity score. Active smokers had a significantly lower in-hospital (p < 0.001) and 30-day (p < 0.001) mortality compared with non-smokers and previous smokers; this was confirmed after adjustment for all baseline and procedural confounders, and the propensity score. In conclusion, in our population, active smoking was significantly associated with improved epicardial recanalization and lower in-hospital and 30-day mortality compared with previous and non-smoking history.

Original language	English
Article number	6722
Number of pages	13
Journal	Journal of Clinical Medicine
Volume	11
Issue number	22
DOIs	https://doi.org/10.3390/jcm11226722
Publication status	Published - 13 Nov 2022

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10.3390/jcm11226722Licence: CC BY

Cite this

De Luca, G., Algowhary, M., Uguz, B., Oliveira, D. C., Ganyukov, V., Zimbakov, Z., Cercek, M., Jensen, L. O., Loh, P. H., Calmac, L., Ferrer, G. R. I., Quadros, A., Milewski, M., Scotto D'Uccio, F., von Birgelen, C., Versaci, F., Ten Berg, J., Casella, G., Wong Sung Lung, A., ... Verdoia, M. (2022). Impact of Smoking Status on Mortality in STEMI Patients Undergoing Mechanical Reperfusion for STEMI: Insights from the ISACS-STEMI COVID-19 Registry. Journal of Clinical Medicine, 11(22), Article 6722. https://doi.org/10.3390/jcm11226722

@article{25257625d753489fb27c7cbe9c301ec1,

title = "Impact of Smoking Status on Mortality in STEMI Patients Undergoing Mechanical Reperfusion for STEMI: Insights from the ISACS-STEMI COVID-19 Registry",

abstract = "The so-called {"}smoking paradox{"}, conditioning lower mortality in smokers among STEMI patients, has seldom been addressed in the settings of modern primary PCI protocols. The ISACS-STEMI COVID-19 is a large-scale retrospective multicenter registry addressing in-hospital mortality, reperfusion, and 30-day mortality among primary PCI patients in the era of the COVID-19 pandemic. Among the 16,083 STEMI patients, 6819 (42.3%) patients were active smokers, 2099 (13.1%) previous smokers, and 7165 (44.6%) non-smokers. Despite the impaired preprocedural recanalization (p < 0.001), active smokers had a significantly better postprocedural TIMI flow compared with non-smokers (p < 0.001); this was confirmed after adjustment for all baseline and procedural confounders, and the propensity score. Active smokers had a significantly lower in-hospital (p < 0.001) and 30-day (p < 0.001) mortality compared with non-smokers and previous smokers; this was confirmed after adjustment for all baseline and procedural confounders, and the propensity score. In conclusion, in our population, active smoking was significantly associated with improved epicardial recanalization and lower in-hospital and 30-day mortality compared with previous and non-smoking history.",

author = "{De Luca}, Giuseppe and Magdy Algowhary and Berat Uguz and Oliveira, {Dinaldo C} and Vladimir Ganyukov and Zan Zimbakov and Miha Cercek and Jensen, {Lisette Okkels} and Loh, {Poay Huan} and Lucian Calmac and Ferrer, {Gerard Roura I} and Alexandre Quadros and Marek Milewski and {Scotto D'Uccio}, Fortunato and {von Birgelen}, Clemens and Francesco Versaci and {Ten Berg}, Jurrien and Gianni Casella and {Wong Sung Lung}, Aaron and Petr Kala and {D{\'i}ez Gil}, {Jos{\'e} Luis} and Xavier Carrillo and Maurits Dirksen and Becerra-Munoz, {Victor M} and Lee, {Michael Kang-Yin} and Juzar, {Dafsah Arifa} and Joaquim, {Rodrigo de Moura} and Roberto Paladino and Davor Milicic and Periklis Davlouros and Nikola Bakraceski and Filippo Zilio and Luca Donazzan and Adriaan Kraaijeveld and Gennaro Galasso and Lux Arpad and Marinucci Lucia and Guiducci Vincenzo and Maurizio Menichelli and Alessandra Scoccia and Yamac, {Aylin Hatice} and {Ugur Mert}, Kadir and {Flores Rios}, Xacobe and Tomas Kovarnik and Michal Kidawa and Jos{\`e} Moreu and Flavien Vincent and Enrico Fabris and Mart{\'i}nez-Luengas, {I{\~n}igo Lozano} and Marco Boccalatte and {Bosa Ojeda}, Francisco and Carlos Arellano-Serrano and Gianluca Caiazzo and Giuseppe Cirrincione and Hsien-Li Kao and {Sanchis For{\'e}s}, Juan and Luigi Vignali and Helder Pereira and Stephane Manzo and Santiago Ordo{\~n}ez and {\"O}zkan, {Alev Arat} and Bruno Scheller and Heidi Lehtola and Rui Teles and Christos Mantis and Ylitalo Antti and Silveira, {Jo{\~a}o Ant{\'o}nio Brum} and Rodrigo Zoni and Ivan Bessonov and Stefano Savonitto and George Kochiadakis and Dimitrios Alexopulos and Uribe, {Carlos E} and John Kanakakis and Benjamin Faurie and Gabriele Gabrielli and Barrios, {Alejandro Gutierrez} and Bachini, {Juan Pablo} and Alex Rocha and Tam, {Frankie Chor-Cheung} and Alfredo Rodriguez and Lukito, {Antonia Anna} and Veauthyelau Saint-Joy and Gustavo Pessah and Andrea Tuccillo and Giuliana Cortese and Guido Parodi and Bouraghda, {Mohamed Abed} and Elvin Kedhi and Pablo Lamelas and Harry Suryapranata and Matteo Nardin and Monica Verdoia",

note = "Publisher Copyright: {\textcopyright} 2022 by the authors.",

year = "2022",

month = nov,

day = "13",

doi = "10.3390/jcm11226722",

language = "English",

volume = "11",

journal = "Journal of Clinical Medicine",

issn = "2077-0383",

publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",

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De Luca, G, Algowhary, M, Uguz, B, Oliveira, DC, Ganyukov, V, Zimbakov, Z, Cercek, M, Jensen, LO, Loh, PH, Calmac, L, Ferrer, GRI, Quadros, A, Milewski, M, Scotto D'Uccio, F, von Birgelen, C, Versaci, F, Ten Berg, J, Casella, G, Wong Sung Lung, A, Kala, P, Díez Gil, JL, Carrillo, X, Dirksen, M, Becerra-Munoz, VM, Lee, MK-Y, Juzar, DA, Joaquim, RDM, Paladino, R, Milicic, D, Davlouros, P, Bakraceski, N, Zilio, F, Donazzan, L, Kraaijeveld, A, Galasso, G, Arpad, L, Lucia, M, Vincenzo, G, Menichelli, M, Scoccia, A, Yamac, AH, Ugur Mert, K, Flores Rios, X, Kovarnik, T, Kidawa, M, Moreu, J, Vincent, F, Fabris, E, Martínez-Luengas, IL, Boccalatte, M, Bosa Ojeda, F, Arellano-Serrano, C, Caiazzo, G, Cirrincione, G, Kao, H-L, Sanchis Forés, J, Vignali, L, Pereira, H, Manzo, S, Ordoñez, S, Özkan, AA, Scheller, B, Lehtola, H, Teles, R, Mantis, C, Antti, Y, Silveira, JAB, Zoni, R, Bessonov, I, Savonitto, S, Kochiadakis, G, Alexopulos, D, Uribe, CE, Kanakakis, J, Faurie, B, Gabrielli, G, Barrios, AG, Bachini, JP, Rocha, A, Tam, FC-C, Rodriguez, A, Lukito, AA, Saint-Joy, V, Pessah, G, Tuccillo, A, Cortese, G, Parodi, G, Bouraghda, MA, Kedhi, E, Lamelas, P, Suryapranata, H, Nardin, M & Verdoia, M 2022, 'Impact of Smoking Status on Mortality in STEMI Patients Undergoing Mechanical Reperfusion for STEMI: Insights from the ISACS-STEMI COVID-19 Registry', Journal of Clinical Medicine, vol. 11, no. 22, 6722. https://doi.org/10.3390/jcm11226722

TY - JOUR

T1 - Impact of Smoking Status on Mortality in STEMI Patients Undergoing Mechanical Reperfusion for STEMI

T2 - Insights from the ISACS-STEMI COVID-19 Registry

AU - De Luca, Giuseppe

AU - Algowhary, Magdy

AU - Uguz, Berat

AU - Oliveira, Dinaldo C

AU - Ganyukov, Vladimir

AU - Zimbakov, Zan

AU - Cercek, Miha

AU - Jensen, Lisette Okkels

AU - Loh, Poay Huan

AU - Calmac, Lucian

AU - Ferrer, Gerard Roura I

AU - Quadros, Alexandre

AU - Milewski, Marek

AU - Scotto D'Uccio, Fortunato

AU - von Birgelen, Clemens

AU - Versaci, Francesco

AU - Ten Berg, Jurrien

AU - Casella, Gianni

AU - Wong Sung Lung, Aaron

AU - Kala, Petr

AU - Díez Gil, José Luis

AU - Carrillo, Xavier

AU - Dirksen, Maurits

AU - Becerra-Munoz, Victor M

AU - Lee, Michael Kang-Yin

AU - Juzar, Dafsah Arifa

AU - Joaquim, Rodrigo de Moura

AU - Paladino, Roberto

AU - Milicic, Davor

AU - Davlouros, Periklis

AU - Bakraceski, Nikola

AU - Zilio, Filippo

AU - Donazzan, Luca

AU - Kraaijeveld, Adriaan

AU - Galasso, Gennaro

AU - Arpad, Lux

AU - Lucia, Marinucci

AU - Vincenzo, Guiducci

AU - Menichelli, Maurizio

AU - Scoccia, Alessandra

AU - Yamac, Aylin Hatice

AU - Ugur Mert, Kadir

AU - Flores Rios, Xacobe

AU - Kovarnik, Tomas

AU - Kidawa, Michal

AU - Moreu, Josè

AU - Vincent, Flavien

AU - Fabris, Enrico

AU - Martínez-Luengas, Iñigo Lozano

AU - Boccalatte, Marco

AU - Bosa Ojeda, Francisco

AU - Arellano-Serrano, Carlos

AU - Caiazzo, Gianluca

AU - Cirrincione, Giuseppe

AU - Kao, Hsien-Li

AU - Sanchis Forés, Juan

AU - Vignali, Luigi

AU - Pereira, Helder

AU - Manzo, Stephane

AU - Ordoñez, Santiago

AU - Özkan, Alev Arat

AU - Scheller, Bruno

AU - Lehtola, Heidi

AU - Teles, Rui

AU - Mantis, Christos

AU - Antti, Ylitalo

AU - Silveira, João António Brum

AU - Zoni, Rodrigo

AU - Bessonov, Ivan

AU - Savonitto, Stefano

AU - Kochiadakis, George

AU - Alexopulos, Dimitrios

AU - Uribe, Carlos E

AU - Kanakakis, John

AU - Faurie, Benjamin

AU - Gabrielli, Gabriele

AU - Barrios, Alejandro Gutierrez

AU - Bachini, Juan Pablo

AU - Rocha, Alex

AU - Tam, Frankie Chor-Cheung

AU - Rodriguez, Alfredo

AU - Lukito, Antonia Anna

AU - Saint-Joy, Veauthyelau

AU - Pessah, Gustavo

AU - Tuccillo, Andrea

AU - Cortese, Giuliana

AU - Parodi, Guido

AU - Bouraghda, Mohamed Abed

AU - Kedhi, Elvin

AU - Lamelas, Pablo

AU - Suryapranata, Harry

AU - Nardin, Matteo

AU - Verdoia, Monica

PY - 2022/11/13

Y1 - 2022/11/13

N2 - The so-called "smoking paradox", conditioning lower mortality in smokers among STEMI patients, has seldom been addressed in the settings of modern primary PCI protocols. The ISACS-STEMI COVID-19 is a large-scale retrospective multicenter registry addressing in-hospital mortality, reperfusion, and 30-day mortality among primary PCI patients in the era of the COVID-19 pandemic. Among the 16,083 STEMI patients, 6819 (42.3%) patients were active smokers, 2099 (13.1%) previous smokers, and 7165 (44.6%) non-smokers. Despite the impaired preprocedural recanalization (p < 0.001), active smokers had a significantly better postprocedural TIMI flow compared with non-smokers (p < 0.001); this was confirmed after adjustment for all baseline and procedural confounders, and the propensity score. Active smokers had a significantly lower in-hospital (p < 0.001) and 30-day (p < 0.001) mortality compared with non-smokers and previous smokers; this was confirmed after adjustment for all baseline and procedural confounders, and the propensity score. In conclusion, in our population, active smoking was significantly associated with improved epicardial recanalization and lower in-hospital and 30-day mortality compared with previous and non-smoking history.

AB - The so-called "smoking paradox", conditioning lower mortality in smokers among STEMI patients, has seldom been addressed in the settings of modern primary PCI protocols. The ISACS-STEMI COVID-19 is a large-scale retrospective multicenter registry addressing in-hospital mortality, reperfusion, and 30-day mortality among primary PCI patients in the era of the COVID-19 pandemic. Among the 16,083 STEMI patients, 6819 (42.3%) patients were active smokers, 2099 (13.1%) previous smokers, and 7165 (44.6%) non-smokers. Despite the impaired preprocedural recanalization (p < 0.001), active smokers had a significantly better postprocedural TIMI flow compared with non-smokers (p < 0.001); this was confirmed after adjustment for all baseline and procedural confounders, and the propensity score. Active smokers had a significantly lower in-hospital (p < 0.001) and 30-day (p < 0.001) mortality compared with non-smokers and previous smokers; this was confirmed after adjustment for all baseline and procedural confounders, and the propensity score. In conclusion, in our population, active smoking was significantly associated with improved epicardial recanalization and lower in-hospital and 30-day mortality compared with previous and non-smoking history.

U2 - 10.3390/jcm11226722

DO - 10.3390/jcm11226722

M3 - Article

C2 - 36431198

SN - 2077-0383

VL - 11

JO - Journal of Clinical Medicine

JF - Journal of Clinical Medicine

IS - 22

M1 - 6722

ER -