The Smoker's Paradox in Acute Coronary Syndrome
Author Information
Author(s): Aune Erlend, Røislien Jo, Mathisen Mariann, Thelle Dag S, Otterstad Jan Erik
Primary Institution: Vestfold Hospital Trust, Norway
Hypothesis
Does the 'smoker's paradox' exist in patients with acute coronary syndrome?
Conclusion
The 'smoker's paradox' was observed in some studies of AMI patients in the pre-thrombolytic and thrombolytic era, whereas no studies of a contemporary population with acute coronary syndrome have found evidence for such a paradox.
Supporting Evidence
- Six studies observed a 'smoker's paradox' in AMI patients.
- Five studies did not support the paradox and included contemporary management.
- Studies from the 1980s and 1990s showed different outcomes compared to recent studies.
Takeaway
Some studies suggest that smokers might do better after a heart attack than non-smokers, but newer studies show this isn't true anymore.
Methodology
A systematic review of studies published by September 2010, including literature searches and independent review of titles and abstracts.
Potential Biases
Potential publication bias and residual confounding due to differences in patient populations and treatment strategies.
Limitations
The review may have omitted relevant studies and did not explore associations between smoking status and non-fatal cardiovascular events.
Participant Demographics
Included hospitalized patients with acute coronary syndrome, with a focus on smoking status.
Digital Object Identifier (DOI)
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