Table 1 Study characteristics and mortality rates according to smoking status at index event
From: The "smoker's paradox" in patients with acute coronary syndrome: a systematic review
Study | Paradox? | Time symptoms to inclusion | Publ. | Enroll. | Index Event | n | Current (C) n (age) | Former (F) n (age) | Never (N) n (age) | Follow -up | Total mortality | Adjusted mortality rates with 95% confidence interval | ||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Â | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â | C | F | N | Â |
Randomised clinical trials in STEMI patients (thrombolytic treatment) | ||||||||||||||
GUSTO-1 [13] | Yes | 3.2 ± 1.65 h | 1995 | 90 to 93 | STEMI | 40,599 | 17,507 (55) | 11,117 (64) | 11,975 (66) | 30d | 4.0% | 6.7% | 10.3% | OR 1.25 (1.11 to 1.39) N vs. C |
Barbash et al. [12] | Yes | 3.0 ± 1.6 h | 1993 | 88 to 89 | STEMI | 8,259 | 3,649 (58) | 2,244 (64) | 2,366 (67) | 6 m | 7.7% | 12.1% | 17.6% | OR 1.35 (1.12 to 1.61) N vs. C+F |
GISSI-2 [23] | No | < 3 h in 70% | 1998 | 88 to 89 | STEMI | 9,694 | 5,151 (57) | 1,932 (64) | 2,611 (68) | In-hosp. | 4.7% | 7.6% | 13.8% | OR 0.80 (0.60 to 1.07) C vs. N OR 0.97 (0.70 to 1.35) F vs. N |
Randomised clinical trials in STEMI patients (invasive treatment) | ||||||||||||||
CADILLAC [27] | No | < 12 h | 2004 | 97 to 99 | STEMI | 2,082 | 898 (53) | 546 (64) | 638 (65) | 1 y | 2.9% | 3.7% | 6.6% | HR 0.96 (0.52 to 1.76) C vs. N |
Randomised clinical trials in patients with NSTE-ACS (invasive treatment) | ||||||||||||||
No | < 24 h | 2008 | 01 to 02 | NSTE -ACS | 9,971 | 2,404 (61) | 3,491 (69) | 4,076 (70) | 1 y | 6.5% | 9.1% | 6.7% | HR 1.77 (1.42 to 2.21) C vs. N | |
Multi-centre post-AMI randomised trials | ||||||||||||||
TRACE [21] | No | 2 to 6 d | 1999 | 90 to 92 | AMI | 6,485 | 3,341 (64) | 1,420 (71) | 1,724 (74) | 3 y | 26 to 27% | 38 to 39% | 42 to 43% | HR 1.04 (0.93 to 1.15) C vs. N |
OPTIMAAL [20] | No | < 10 d | 2004 | 98 to 99 | AMI | 5,475 | 1,832 (62) | 1,867 (69) | 1,776 (71) | 2.7 y | 16.3% | Incl. in C | 19.3% | HR 1.08 (0.93 to 1.25) C+F vs. N |
Single-centre observational studies of patients with AMI | ||||||||||||||
Mølstad [25] | Yes | NA | 1991 | 82 to 84 | AMI | 484 | 184 (61) | Incl. in N | 456 (70) | 3 m | 11 to 13% | Incl. in N | 32 to 34% | HR 0.62 (0.36 to 1.04) C vs. N+F HR 0.55 (0.33 to 0.93) C vs. N+F |
Bettencourt et al. [14] | No | NA | 2004 | 01 to 02 | ACS | 901 | 369 (58) | Incl. in C | 532 (69) | In-hosp. | 2.6% | Incl. in F | 6.6% | OR 0.96 (0.38 to 2.41) C+F vs. N |
Gaspar et al. [16] | No | NA | 2009 | 04 to 07 | ACS | 1,228 | 450 (58) | Incl. in C | 778 (68) | 6 m | 9.3% | Incl. in C | 13.1% | OR 1.25 (0.61 to 2.54) C+F vs. N |
Aune et al . § [7] | No | NA | 2010 | 03 to 07 | NSTEMI | 381 | 103 (63) | Incl. in N | 278 (80) | 1y | 22% | Incl. in N | 27% | HR 2.61 (1.43 to 4.79) C vs. N+F |
Registries | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â | Â |
Gottlieb et al. [17] | No | NA | 1996 | 94 | AMI | 999 | 367 (57) | Incl. in N | 632 (67) | 6 m | 7.9% | Incl. in N | 21.5% | HR 0.84 (0.54 to 1.30) C vs. N+F |
Andrikopoulos et al. [11] | No | < 24 h | 2001 | 93 to 94 | AMI | 5507 | 3,853 (59) | Excluded | 1,654 (70) | In-hosp. | 7.4% | NA | 14.5% | RR 1.12 (0.86 to 1.44) C vs. N |
NRMI 2 [18] | Yes | NA | 2002 | 94 to 97 | AMI | 297,458 | 72,585 (58) | Incl. in N | 224,871 (72) | In-hosp. | 8.0% | Incl. in N | 16.4% | OR 0.86 (0.83 to 0.90) C vs. N+F |
ARIAM [26] | Yes | < 24 h criterion | 2004 | 95 to 01 | AMI | 17,761 | 5,796 (57) | 3,494 (67) | 8,471 (70) | ICU/CCU | 5.0% | 9.3% | 13.3% | OR 0.77 (0.66 to 0.91) C vs. N |
| Â | Â | Â | Â | Â | UAP | 7,795 | 1,721 | 1,950 | 4,124 | ICU/CCU | 0.7% | 1.0% | 1.5% | OR 0.81 (0.48 to 1.36) C vs. N |
IBERICA [15] | Yes | < 12 h in 82% | 2007 | 97 to 98 | AMI | 7,796 | 3,057 (56) | 1,730 | 2,839 (65) | 28 d | 8.9% | 16.9% | 20.1% | OR 0.57 (0.42 to 0.78) C vs. N |
GRACE [19] | No | NA | 2005 | 99 to 02 | ACS | 19,325 | 5,276 (57) | 5,691 (67) | 8,358 (71) | In-hosp. | 3.3% | 4.5% | 6.9% | OR 1.01 (0.80 to 1.27) C vs. N |