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 D oppler echocardiography ( TDI ) were performed within 48–72 hours after onset of chest pain. Peak early ( E m) and late ( A m) diastolic velocities, peak systolic ( S m) mitral annular velocities and time intervals were recorded with TDI . The MPI , ratio of E m/ A m, and E / E m were calculated. Results: Baseline demographic and angiographic characteristics such as G ensini 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 E m/ A m 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 .