Significance of smoking in patients receiving thrombolytic therapy for acute myocardial infarction

Abstract

Background: Cigarette smoking is associated with increased coronary morbidity and mortality, which has multiple de¬leterious effect on atherogenesis, thrombosis and arrythmogenesis. But some investigators have noted that hospital mortality after acute myocardial infarction is lower in patients who smoke than nonsmokers. To evaluate the initial and 6 months la¬ter association of smoking and thrombolytic therapy, we analyzed the results of streptokinase complications in acute myo¬cardial infarction. Method and Result: This study involved 205 patients. Patients were divided into three groups: group I - non smoker 43 patients (those patients who never smoked 30 men, 13 women); group 2 - ex smoker 71 patients (those who quit smo¬king > 1 month before infarction, 66 men, 5 women ); group 3 - active smoker 91 patients, 83 men and 8 women. Patients admitted to the hospital in the first 6 hours of Myocardial Infarction (Ml) and received 1.500.000 units of streptokinase as intravenous route. During in patient follow up rhythm and conduction disturbances, shock, congestive heart failure and de¬ath in patients with acute myocardial infarction is merely established. Coronary angiography (CAG) is performed after 6 ± 2 weeks to the 61 patients who still have angina. In the first 6 months follow - up reinfarction and mortality rate was much more in the nonsmoker ones (p < 0.001) Conclusion: Smoking patients who received thrombolytic therapy after acute myocardial infarction have significantly worse progression in hospital but after 6 months death and reinfarction was established more in nonsmokers than smokers. But Diabetes Mellitus ( p < 0.05 }, hypercholesterolemia ( p < 0.05 ) and family history percentage (p < 0.001 ) was high in nonsmokers. Under these circumstances smoking must be absolutely stopped .