Impacto del tabaquismo en la evolución de los pacientes internados por síndromes isquémicos agudos

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Abstract

Study Objective: To asses the impact of smoking status on the outcome of patients who presented acute coronary syndromes (ACS) on admission, by means of a survey of the Sociedad Argentina de Cardiología databases. 

Research design and methods: Boyh STRATEG-SIA and Registro IAM-1999 databases were surveyed. Patient outcomes were analyzed in accordance to smoking status and diagnosis at admission. 

Results: In both groups, smokers were younger and more frequently male. Smokers presenting an ACS without ST segment elevation had less frequent chronic stable angina and previous myocardial revascularization. No significant differences in the incidence of myocardial infarction between smokers and non-smokers presenting an ACS without ST elevation were observed. In those patients ho presenten ACS with ST segment elevation, reinfarction rates were similar in both subgroups. However, smokers had lower in-hospital mortality. Logistic regression analysis performed in the ACS with associated to a higher mortality were: age > 65 years, systolic blood pressure < 100 mm Hg and Killip & Kimbal index ≥ B. Current somking status was independently associated with a lower in-hospital mortality (OR 0.27 95% CI 0.10-0.69; p = 0.006).

Conclusions: Smokers presenting ACS with ST segment elevation show a more favorable shot-term evolution. This lower mortality rate is not observed when the qualifying syndromes is an ACS without ST elevation.