• Yong Hoon Kim, Ae-Young Her, Myung Ho Jeong, Byeong-Keuk Kim, Sung-Jin Hong, Seunghwan Kim, Chul-Min Ahn, Jung-Sun Kim, Young-Guk Ko, Donghoon Choi, Myeong-Ki Hong, and Yangsoo Jang.
• Division of Cardiology, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Republic of Korea. Electronic address: yhkim02@kangwon.ac.kr.
• Am. J. Med. Sci. 2022 Nov 1; 364 (5): 612623612-623.

BackgroundSmoking is linked with increased risk of cardiovascular events among diabetic patients. Prediabetes is associated with increased risk for microvascular and macrovascular complications. We compared the 2-year clinical outcomes of current smoking between prediabetic and type 2 diabetes mellitus (T2DM) patients with acute myocardial infarction (AMI) after newer-generation drug-eluting stent (DES) implantation.MethodsA total of 5161 AMI patients who were currently smoking were classified into normoglycemia (group A: 1,416), prediabetes (group B: 1,740), and T2DM (group C: 2,005) groups. The primary endpoint was major adverse cardiac events (MACEs), defined as all-cause death, recurrent myocardial infarction and any repeat revascularization. The secondary endpoint was the occurrence of stent thrombosis (ST) and stroke.ResultsThe cumulative incidences of all primary and secondary endpoints including MACEs (adjusted hazard ratio [aHR]: 1.150; 95% confidence interval [CI]: 0.891-1.484; P = 0.284), ST, and stroke were similar between group B and group C. The cumulative incidences of MACEs (aHR: 1.385; 95% CI: 1.007-1.904; P = 0.045) and all-cause death or MI were significantly higher in group B than in group A. The cumulative incidences of MACEs (aHR: 1.572; 95% CI: 1.157-2.137; P = 0.004), all-cause death, Re-MI, and all-cause death or MI were significantly higher in group C than in group A.ConclusionsCurrent smoking leads to worse clinical outcomes in patients with AMI and prediabetes, and thus, similarly to T2DM patients, more attention and more intensive treatment strategy including quitting smoking would be advantageous.Copyright © 2022 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

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