'Smoker's paradox' in young patients with acute myocardial infarction

Kang Yin Chen, Seung Woon Rha, Yong Jian Li, Zhe Jin, Yoshiyasu Minami, Ji Young Park, Kanhaiya L. Poddar, Sureshkumar Ramasamy, Lin Wang, Guang Ping Li, Cheol Ung Choi, Dong Joo Oh, Myung Ho Jeong, Myung Ho Jeong, Young Jo Kim, Chong Jin Kim, Myeong Chan Cho, Young Keun Ahn, Jong Hyun Kim, Shung Chull ChaeSeung Ho Hur, In Whan Seong, Taek Jong Hong, Dong Hoon Choi, Jei Keon Chae, Jae Young Rhew, Doo Il Kim, In Ho Chae, Jung Han Yoon, Bon Kwon Koo, Byung Ok Kim, Myoung Yong Lee, Kee Sik Kim, Jin Yong Hwang, Seok Kyu Oh, Nae Hee Lee, Kyoung Tae Jeong, Seung Jea Tahk, Jang Ho Bae, Keum Soo Park, Kyoo Rok Han, Tae Hoon Ahn, Moo Hyun Kim, Ju Young Yang, Chong Yun Rhim, Hyeon Cheol Gwon, Seong Wook Park, Young Youp Koh, Seung Jae Joo, Soo Joong Kim, Dong Kyu Jin, Jin Man Cho, Jeong Gwan Cho, Wook Sung Chung, Yang Soo Jang, Ki Bae Seung, Seung Park Jung

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Of the patients suffering from acute myocardial infarction (AMI), smokers are younger than non-smokers, which may be a major confounding factor causing 'smoker's paradox'. Therefore, in the present study we evaluated the 'smoker's paradox' in young patients with AMI. In all, 1218 young AMI patients (≤ 45 years of age), comprising 990 smokers and 228 non-smokers, were enrolled in the present study. In-hospital and 8 months clinical outcomes were compared between the smokers and non-smokers. Baseline clinical characteristics showed that smokers were more likely to be male (97.9% vs 72.4%; P < 0.001) and had a higher rate of ST-segment elevation myocardial infarction (71.3% vs 59.5%; P = 0.001) than non-smokers. Clinical outcomes showed that smokers had lower rates of in-hospital cardiac death (0.8% vs 3.5%; P = 0.004), total death (0.8% vs 3.5%; P = 0.004) and 8 months cardiac death (1.1% vs 3.9%; P = 0.006) and total death (1.3% vs 4.4%; P = 0.005) than non-smokers. Multivariable logistic analysis showed that current smoking was an independent protective predictor of 8 months cardiac death (odds ratio (OR) 0.25; 95% confidence interval (CI) 0.07-0.92; P = 0.037) and total death (OR 0.26; 95% CI 0.09-0.82; P = 0.021). Subgroup analysis in patients who underwent percutaneous coronary intervention after AMI showed that current smoking was an independent protective predictor of 8 months total major adverse cardiac events (OR 0.47; 95% CI 0.23-0.97; P = 0.041). Current smoking seems to be associated with better clinical outcomes in young patients with AMI, suggesting the existence of the 'smoker's paradox' in this particular subset of patients.

Original languageEnglish
Pages (from-to)630-635
Number of pages6
JournalClinical and Experimental Pharmacology and Physiology
Volume39
Issue number7
DOIs
Publication statusPublished - 2012 Jun 27

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Myocardial Infarction
Smoking
Odds Ratio
Confidence Intervals
Percutaneous Coronary Intervention

All Science Journal Classification (ASJC) codes

  • Physiology
  • Pharmacology
  • Physiology (medical)

Cite this

Chen, K. Y., Rha, S. W., Li, Y. J., Jin, Z., Minami, Y., Park, J. Y., ... Jung, S. P. (2012). 'Smoker's paradox' in young patients with acute myocardial infarction. Clinical and Experimental Pharmacology and Physiology, 39(7), 630-635. https://doi.org/10.1111/j.1440-1681.2012.05721.x
Chen, Kang Yin ; Rha, Seung Woon ; Li, Yong Jian ; Jin, Zhe ; Minami, Yoshiyasu ; Park, Ji Young ; Poddar, Kanhaiya L. ; Ramasamy, Sureshkumar ; Wang, Lin ; Li, Guang Ping ; Choi, Cheol Ung ; Oh, Dong Joo ; Jeong, Myung Ho ; Jeong, Myung Ho ; Kim, Young Jo ; Kim, Chong Jin ; Cho, Myeong Chan ; Ahn, Young Keun ; Kim, Jong Hyun ; Chae, Shung Chull ; Hur, Seung Ho ; Seong, In Whan ; Hong, Taek Jong ; Choi, Dong Hoon ; Chae, Jei Keon ; Rhew, Jae Young ; Kim, Doo Il ; Chae, In Ho ; Yoon, Jung Han ; Koo, Bon Kwon ; Kim, Byung Ok ; Lee, Myoung Yong ; Kim, Kee Sik ; Hwang, Jin Yong ; Oh, Seok Kyu ; Lee, Nae Hee ; Jeong, Kyoung Tae ; Tahk, Seung Jea ; Bae, Jang Ho ; Park, Keum Soo ; Han, Kyoo Rok ; Ahn, Tae Hoon ; Kim, Moo Hyun ; Yang, Ju Young ; Rhim, Chong Yun ; Gwon, Hyeon Cheol ; Park, Seong Wook ; Koh, Young Youp ; Joo, Seung Jae ; Kim, Soo Joong ; Jin, Dong Kyu ; Cho, Jin Man ; Cho, Jeong Gwan ; Chung, Wook Sung ; Jang, Yang Soo ; Seung, Ki Bae ; Jung, Seung Park. / 'Smoker's paradox' in young patients with acute myocardial infarction. In: Clinical and Experimental Pharmacology and Physiology. 2012 ; Vol. 39, No. 7. pp. 630-635.
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title = "'Smoker's paradox' in young patients with acute myocardial infarction",
abstract = "Of the patients suffering from acute myocardial infarction (AMI), smokers are younger than non-smokers, which may be a major confounding factor causing 'smoker's paradox'. Therefore, in the present study we evaluated the 'smoker's paradox' in young patients with AMI. In all, 1218 young AMI patients (≤ 45 years of age), comprising 990 smokers and 228 non-smokers, were enrolled in the present study. In-hospital and 8 months clinical outcomes were compared between the smokers and non-smokers. Baseline clinical characteristics showed that smokers were more likely to be male (97.9{\%} vs 72.4{\%}; P < 0.001) and had a higher rate of ST-segment elevation myocardial infarction (71.3{\%} vs 59.5{\%}; P = 0.001) than non-smokers. Clinical outcomes showed that smokers had lower rates of in-hospital cardiac death (0.8{\%} vs 3.5{\%}; P = 0.004), total death (0.8{\%} vs 3.5{\%}; P = 0.004) and 8 months cardiac death (1.1{\%} vs 3.9{\%}; P = 0.006) and total death (1.3{\%} vs 4.4{\%}; P = 0.005) than non-smokers. Multivariable logistic analysis showed that current smoking was an independent protective predictor of 8 months cardiac death (odds ratio (OR) 0.25; 95{\%} confidence interval (CI) 0.07-0.92; P = 0.037) and total death (OR 0.26; 95{\%} CI 0.09-0.82; P = 0.021). Subgroup analysis in patients who underwent percutaneous coronary intervention after AMI showed that current smoking was an independent protective predictor of 8 months total major adverse cardiac events (OR 0.47; 95{\%} CI 0.23-0.97; P = 0.041). Current smoking seems to be associated with better clinical outcomes in young patients with AMI, suggesting the existence of the 'smoker's paradox' in this particular subset of patients.",
author = "Chen, {Kang Yin} and Rha, {Seung Woon} and Li, {Yong Jian} and Zhe Jin and Yoshiyasu Minami and Park, {Ji Young} and Poddar, {Kanhaiya L.} and Sureshkumar Ramasamy and Lin Wang and Li, {Guang Ping} and Choi, {Cheol Ung} and Oh, {Dong Joo} and Jeong, {Myung Ho} and Jeong, {Myung Ho} and Kim, {Young Jo} and Kim, {Chong Jin} and Cho, {Myeong Chan} and Ahn, {Young Keun} and Kim, {Jong Hyun} and Chae, {Shung Chull} and Hur, {Seung Ho} and Seong, {In Whan} and Hong, {Taek Jong} and Choi, {Dong Hoon} and Chae, {Jei Keon} and Rhew, {Jae Young} and Kim, {Doo Il} and Chae, {In Ho} and Yoon, {Jung Han} and Koo, {Bon Kwon} and Kim, {Byung Ok} and Lee, {Myoung Yong} and Kim, {Kee Sik} and Hwang, {Jin Yong} and Oh, {Seok Kyu} and Lee, {Nae Hee} and Jeong, {Kyoung Tae} and Tahk, {Seung Jea} and Bae, {Jang Ho} and Park, {Keum Soo} and Han, {Kyoo Rok} and Ahn, {Tae Hoon} and Kim, {Moo Hyun} and Yang, {Ju Young} and Rhim, {Chong Yun} and Gwon, {Hyeon Cheol} and Park, {Seong Wook} and Koh, {Young Youp} and Joo, {Seung Jae} and Kim, {Soo Joong} and Jin, {Dong Kyu} and Cho, {Jin Man} and Cho, {Jeong Gwan} and Chung, {Wook Sung} and Jang, {Yang Soo} and Seung, {Ki Bae} and Jung, {Seung Park}",
year = "2012",
month = "6",
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pages = "630--635",
journal = "Clinical and Experimental Pharmacology and Physiology",
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Chen, KY, Rha, SW, Li, YJ, Jin, Z, Minami, Y, Park, JY, Poddar, KL, Ramasamy, S, Wang, L, Li, GP, Choi, CU, Oh, DJ, Jeong, MH, Jeong, MH, Kim, YJ, Kim, CJ, Cho, MC, Ahn, YK, Kim, JH, Chae, SC, Hur, SH, Seong, IW, Hong, TJ, Choi, DH, Chae, JK, Rhew, JY, Kim, DI, Chae, IH, Yoon, JH, Koo, BK, Kim, BO, Lee, MY, Kim, KS, Hwang, JY, Oh, SK, Lee, NH, Jeong, KT, Tahk, SJ, Bae, JH, Park, KS, Han, KR, Ahn, TH, Kim, MH, Yang, JY, Rhim, CY, Gwon, HC, Park, SW, Koh, YY, Joo, SJ, Kim, SJ, Jin, DK, Cho, JM, Cho, JG, Chung, WS, Jang, YS, Seung, KB & Jung, SP 2012, ''Smoker's paradox' in young patients with acute myocardial infarction', Clinical and Experimental Pharmacology and Physiology, vol. 39, no. 7, pp. 630-635. https://doi.org/10.1111/j.1440-1681.2012.05721.x

'Smoker's paradox' in young patients with acute myocardial infarction. / Chen, Kang Yin; Rha, Seung Woon; Li, Yong Jian; Jin, Zhe; Minami, Yoshiyasu; Park, Ji Young; Poddar, Kanhaiya L.; Ramasamy, Sureshkumar; Wang, Lin; Li, Guang Ping; Choi, Cheol Ung; Oh, Dong Joo; Jeong, Myung Ho; Jeong, Myung Ho; Kim, Young Jo; Kim, Chong Jin; Cho, Myeong Chan; Ahn, Young Keun; Kim, Jong Hyun; Chae, Shung Chull; Hur, Seung Ho; Seong, In Whan; Hong, Taek Jong; Choi, Dong Hoon; Chae, Jei Keon; Rhew, Jae Young; Kim, Doo Il; Chae, In Ho; Yoon, Jung Han; Koo, Bon Kwon; Kim, Byung Ok; Lee, Myoung Yong; Kim, Kee Sik; Hwang, Jin Yong; Oh, Seok Kyu; Lee, Nae Hee; Jeong, Kyoung Tae; Tahk, Seung Jea; Bae, Jang Ho; Park, Keum Soo; Han, Kyoo Rok; Ahn, Tae Hoon; Kim, Moo Hyun; Yang, Ju Young; Rhim, Chong Yun; Gwon, Hyeon Cheol; Park, Seong Wook; Koh, Young Youp; Joo, Seung Jae; Kim, Soo Joong; Jin, Dong Kyu; Cho, Jin Man; Cho, Jeong Gwan; Chung, Wook Sung; Jang, Yang Soo; Seung, Ki Bae; Jung, Seung Park.

In: Clinical and Experimental Pharmacology and Physiology, Vol. 39, No. 7, 27.06.2012, p. 630-635.

Research output: Contribution to journalArticle

TY - JOUR

T1 - 'Smoker's paradox' in young patients with acute myocardial infarction

AU - Chen, Kang Yin

AU - Rha, Seung Woon

AU - Li, Yong Jian

AU - Jin, Zhe

AU - Minami, Yoshiyasu

AU - Park, Ji Young

AU - Poddar, Kanhaiya L.

AU - Ramasamy, Sureshkumar

AU - Wang, Lin

AU - Li, Guang Ping

AU - Choi, Cheol Ung

AU - Oh, Dong Joo

AU - Jeong, Myung Ho

AU - Jeong, Myung Ho

AU - Kim, Young Jo

AU - Kim, Chong Jin

AU - Cho, Myeong Chan

AU - Ahn, Young Keun

AU - Kim, Jong Hyun

AU - Chae, Shung Chull

AU - Hur, Seung Ho

AU - Seong, In Whan

AU - Hong, Taek Jong

AU - Choi, Dong Hoon

AU - Chae, Jei Keon

AU - Rhew, Jae Young

AU - Kim, Doo Il

AU - Chae, In Ho

AU - Yoon, Jung Han

AU - Koo, Bon Kwon

AU - Kim, Byung Ok

AU - Lee, Myoung Yong

AU - Kim, Kee Sik

AU - Hwang, Jin Yong

AU - Oh, Seok Kyu

AU - Lee, Nae Hee

AU - Jeong, Kyoung Tae

AU - Tahk, Seung Jea

AU - Bae, Jang Ho

AU - Park, Keum Soo

AU - Han, Kyoo Rok

AU - Ahn, Tae Hoon

AU - Kim, Moo Hyun

AU - Yang, Ju Young

AU - Rhim, Chong Yun

AU - Gwon, Hyeon Cheol

AU - Park, Seong Wook

AU - Koh, Young Youp

AU - Joo, Seung Jae

AU - Kim, Soo Joong

AU - Jin, Dong Kyu

AU - Cho, Jin Man

AU - Cho, Jeong Gwan

AU - Chung, Wook Sung

AU - Jang, Yang Soo

AU - Seung, Ki Bae

AU - Jung, Seung Park

PY - 2012/6/27

Y1 - 2012/6/27

N2 - Of the patients suffering from acute myocardial infarction (AMI), smokers are younger than non-smokers, which may be a major confounding factor causing 'smoker's paradox'. Therefore, in the present study we evaluated the 'smoker's paradox' in young patients with AMI. In all, 1218 young AMI patients (≤ 45 years of age), comprising 990 smokers and 228 non-smokers, were enrolled in the present study. In-hospital and 8 months clinical outcomes were compared between the smokers and non-smokers. Baseline clinical characteristics showed that smokers were more likely to be male (97.9% vs 72.4%; P < 0.001) and had a higher rate of ST-segment elevation myocardial infarction (71.3% vs 59.5%; P = 0.001) than non-smokers. Clinical outcomes showed that smokers had lower rates of in-hospital cardiac death (0.8% vs 3.5%; P = 0.004), total death (0.8% vs 3.5%; P = 0.004) and 8 months cardiac death (1.1% vs 3.9%; P = 0.006) and total death (1.3% vs 4.4%; P = 0.005) than non-smokers. Multivariable logistic analysis showed that current smoking was an independent protective predictor of 8 months cardiac death (odds ratio (OR) 0.25; 95% confidence interval (CI) 0.07-0.92; P = 0.037) and total death (OR 0.26; 95% CI 0.09-0.82; P = 0.021). Subgroup analysis in patients who underwent percutaneous coronary intervention after AMI showed that current smoking was an independent protective predictor of 8 months total major adverse cardiac events (OR 0.47; 95% CI 0.23-0.97; P = 0.041). Current smoking seems to be associated with better clinical outcomes in young patients with AMI, suggesting the existence of the 'smoker's paradox' in this particular subset of patients.

AB - Of the patients suffering from acute myocardial infarction (AMI), smokers are younger than non-smokers, which may be a major confounding factor causing 'smoker's paradox'. Therefore, in the present study we evaluated the 'smoker's paradox' in young patients with AMI. In all, 1218 young AMI patients (≤ 45 years of age), comprising 990 smokers and 228 non-smokers, were enrolled in the present study. In-hospital and 8 months clinical outcomes were compared between the smokers and non-smokers. Baseline clinical characteristics showed that smokers were more likely to be male (97.9% vs 72.4%; P < 0.001) and had a higher rate of ST-segment elevation myocardial infarction (71.3% vs 59.5%; P = 0.001) than non-smokers. Clinical outcomes showed that smokers had lower rates of in-hospital cardiac death (0.8% vs 3.5%; P = 0.004), total death (0.8% vs 3.5%; P = 0.004) and 8 months cardiac death (1.1% vs 3.9%; P = 0.006) and total death (1.3% vs 4.4%; P = 0.005) than non-smokers. Multivariable logistic analysis showed that current smoking was an independent protective predictor of 8 months cardiac death (odds ratio (OR) 0.25; 95% confidence interval (CI) 0.07-0.92; P = 0.037) and total death (OR 0.26; 95% CI 0.09-0.82; P = 0.021). Subgroup analysis in patients who underwent percutaneous coronary intervention after AMI showed that current smoking was an independent protective predictor of 8 months total major adverse cardiac events (OR 0.47; 95% CI 0.23-0.97; P = 0.041). Current smoking seems to be associated with better clinical outcomes in young patients with AMI, suggesting the existence of the 'smoker's paradox' in this particular subset of patients.

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