The Effect of Smoking on Myocardial Performance Index in Middle-Aged Males after First Acute Myocardial Infarction.

Background: Cigarette smoking is associated with increased rates of coronary artery disease and acute myocardial infarction ( MI). Paradoxically, smokers had lower mortality after MI. The purpose of this study was to evaluate the effect of chronic smoking on myocardial performance index ( MPI) in middle-aged men after an acute MI. Material and methods: A total of 429 patients (325 smokers vs. 104 nonsmokers) presenting with acute ST elevation MI were enrolled in this study. Thrombolysis in myocardial infarction ( TIMI) flow of the infarct related artery was measured before and after the primary percutaneous coronary intervention ( PCI), and Gensini score was also calculated. Conventional echocardiography and tissue Doppler echocardiography ( TDI) were performed within 48-72 hours after onset of chest pain. Peak early ( Em) and late ( Am) diastolic velocities, peak systolic ( Sm) mitral annular velocities and time intervals were recorded with TDI. The MPI, ratio of Em/ Am, and E/ Em were calculated. Results: Baseline demographic and angiographic characteristics such as Gensini score, pre and, post PCI TIMI flow were similar in 2 groups. In contrast, LV MPI was preserved among smokers (0.59 ± 0.15 vs. 0.66 ± 0.14, P = 0.01), and Em/ Am values were also higher in smokers (0.84 ± 0.28 vs. 0.75 ± 0.31, P = 0.01). Independent predictors of impaired MPI (≥0.60) were determined as nonsmoking status (odds ratio 2.940, 95% CI 0.98-5.83, P = 0.05), left anterior descending artery stenosis (odds ratio 3.196, 95% CI 1.73-5.91 P = 0.001), and, age (odds ratio 1.12, 95% CI 1.03-1.22, P = 0.01). Conclusions: Despite similar demographic and angiographic characteristics, smoker males had a paradoxically better MPI after acute MI. [ABSTRACT FROM AUTHOR]