Impacto do tabagismo nos desfechos hospitalares de pacientes diagnósticados com IAMCSST em Sergipe: registro victim

Abstract

Background: Smoking is a known risk factor for cardiovascular diseases. Studies have shown a better short-term prognosis in smokers compared to nonsmokers, a phenomenon known in the literature as the "smoker's paradox." However, this issue is still controversial, as there are indications that such results are due only to the smokers' basal characteristics during the period of AMI. Objective: Comparing the hospital outcomes among smokers, ex-smokers and non smokers diagnosed with ST-segment elevation myocardial infarction. Method: This is a cross-sectional study, with a quantitative approach, developed in the period from December 2014 to March 2018 in Aracaju-SE, using the data from the VICTIM Study. A total of 1,082 patients diagnosed with STEMI were divided into three groups based on the history of smoking: 1. Smokers, 2. Ex-smokers and 3. Non smokers. Nonsmokers were used as a control group in the comparison of hospital outcomes. A significant difference was considered when p <0.05. Outcome: Of the 1,082 patients, 324 were smokers, 367 were ex-smokers and 391 were non-smokers. In the in-hospital mortality assessment, the smokers group presented a lower mortality compared to nonsmokers (6.5% vs. 11.1% OR 0.6 95% CI 0.3-1.0, p = 0.035). However, this difference was no longer significant after adjustment for the baseline characteristics of the groups (OR 0.6 95% CI 0.3-1.2, p = 0.154). The difference between the group of former smokers and nonsmokers was not statistically significant before adjustment (11.4% vs 11.2% OR 1.0 95% CI 0.7-1.6, p = 0.856) and after the adjustment (OR 1,0 95% CI 0.5-1.8, p = 0.948). Conclusion: The present study found no significant impact of smoking on in-hospital mortality after adjustment for baseline characteristics of the groups