Smoking Inhibits Early Reduction of Infarct Size in Patients with Acute ST Segment Elevation Myocardial Infarction

Objectives: Early reperfusion therapy in patients with acute ST segment elevation myocardial infarction (STEMI) reduces infarct size. Cigarette smoking theoretically exacerbates reperfusion injury, and may inhibit the reduction. However, long term survival in smoker patients underwent percutaneous coronary intervention (PCI) for STEMI remains controversial. The aim of this study was to investigate the relation between smoking status and reduction of infarct size determined by 99mTc tetrofosmin myocardial perfusion imaging(MPI). Methods: One hundred and nine patients with first STEMI of infarct size...15% treated by PCI were studied (mean age 63.3 years, male 78%, female 22%). All patients underwent repetitiveMPI; 1st: within 7 days, 2nd: 1 months after PCI. Infarct size reduction was determined by the change of the defect size in the polar map. Results: Overall infarct size reduction was 10.5±7.2%. The reduction was significantly smaller in smokers(7.6±6.6%) than in non-smokers(12.5±7.0%), p