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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
            C F N  
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)
SYNERGY [22, 24] 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               
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
      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
  1. ACS, acute coronary syndrome; AMI, acute myocardial infarction; CCU, coronary care unit; HR, hazard ratio; ICU, intensive care unit; OR, odds ratio; NA, not available; NST-ACS, non-ST-segment acute coronary syndrome; NSTEMI, non-ST-segment elevation myocardial infarction; RR, relative risk; STEMI, ST-segment elevation myocardial infarction; UAP, unstable angina pectoris. §The adjusted HR is for the conservative treatment cohort (2003) only. For the invasive cohort (2006) there was no difference in mortality for smokers and non-smokers (data not published).