Ιγνάτιος Οικονομίδης, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Φωτούλα Μπαμπάτσικου, Αναπληρώτρια Καθηγήτρια, Τμήμα Νοσηλευτικής, Πανεπιστήμιο Δυτικής Αττικής
Καλλιρόη Κουρέα, Ειδική Καρδιολόγος, Διδάκτωρ Πανεπιστημίου Αθηνών
Introduction: Smoking is one of the most common risk factors in patients with acute coronary syndrome. For this reason, the negative effects of smoking in patients with acute coronary syndrome and their attitude towards smoking after discharge were investigated. Additionally, the association of passive smoking and acute coronary syndrome, which remains controversial, has been studied.
Purpose: Investigating the correlation of smoking and acute coronary syndrome and the behavior of patients with smoking before and after the episode. A secondary objective is to investigate the effect of passive smoking on acute coronary syndrome.
Methodology: The study was based on 164 male and female patients (103 smokers and 61 passive smokers) who were hospitalized in the Intensive Care Unit and Coronary Care Unit at “ATTIKON” Hospital in Athens with acute coronary syndrome (STEMI, NSTEMI, USAP). In this study, a questionnaire was used as a research tool for collecting data during patient hospitalization. Subsequently, smokers were assessed for their smoking habits by telephone after 3 and 6 months. The degree of dependence of patients on nicotine with the help of the Fagerstrom test was also measured.
Results: Of the 103 smokers, 82 were men and 21 were women. The average age of the patients was 58 years and the average starting age for smoking was 19 years. In the follow-up after 3 months, 70.9% of patients reported having quit smoking. All of those who ceased smoking abstained from it on the day of their discharge. In the second follow up at 6 months, 37.9% had resumed smoking. As regards the lifestyle of patients, the results showed that 67% consumed fatty foods, 53.4% lacked physical exercise, 39.8% were obese, 53.4% had hypertension, 35% had diabetes and 47.6% had hyperlipidemia.
The association of smoking cessation and recurrence rates between age, number of cigarettes and degree of nicotine dependence was assessed by the Fagerstrom test. The 55.3% of the population had a high dependence and lack of self control related to smoking behavior (score 7). The association of smoking cessation at 3 and 6 months with age, the number of cigarettes smoked and the Fagerstrom score showed that patients who quit smoking for 6 consecutive months, had a lower average Fagerstrom score than those who discontinued at 3 but resumed up to 6 months 6.4 (t=2.97, p=0.004). In addition, patients who discontinued for 6 consecutive months smoked less cigarettes a day than patients who discontinued it at 3 but started it again for up to 6 months. (t=3,3, p=0.002).
Concerning the knowledge and correlation between passive smoking and the occurrence of acute coronary syndrome, 61 passive smokers with an average age of 67 years took part. The majority of people were in public places where others smoked (65.6%). A 100% of the participants in this group said that passive smoking is harmful to health and suffered from Acute Coronary Syndromes.
Conclusions: Age did not appear to be associated with the recurrence of smoking behavior. The factors that appeared through this study to be directly related to relapse are the number of cigarettes smoked by patients before their arrival in the hospital and their addiction to nicotine.
Acute Coronary Syndromes, Lifestyle, Passive smoking, Smoking cessation, Myocardial infarction