In-Hospital Outcome among Patients with Acute Coronary Syndrome and Smoking Status Admitted to a Tertiary Care Hospital

Abstract

Objectives: Cigarette smoking is a well-established modifiable risk factor for the development of acute coronary syndrome (ACS). Interestingly, several studies have paradoxically reported lower short-term mortality following ST-segment elevation myocardial infarction (STEMI) among smokers compared to non-smokers. To evaluate the association between in-hospital mortality and smoking status in patients presenting with acute coronary syndrome. Methodology: A prospective cohort study was conducted in the Department of Cardiology, Jinnah Hospital, Lahore, from 01-01-2024 to 30-06-2024. A total of 320 patients diagnosed with ACS were enrolled consecutively, including 160 smokers and 160 non-smokers. All patients received standard treatment including antiplatelets, thrombolytic therapy, and other interventions as clinically indicated. Patients were followed throughout their 7-day in-hospital stay, and outcomes, particularly in-hospital mortality, were recorded. Data were stratified for confounding factors such as age and diabetes mellitus to control for effect modifiers. Results: The mean age of the study population was 51.42 ± 16.66 years. In-hospital mortality was observed in 4.38% of smokers and 10.61% of non-smokers. The relative risk (RR) of in-hospital mortality in relation to smoking status was 41.2, suggesting a significant association. Conclusion: A statistically significant association was found between smoking status and in-hospital mortality in patients presenting with ACS. Effect modifiers such as age and gender influenced outcomes and warrant further investigation.