The enigma of the ‘smoker's paradox’: Results from a single-center registry of patients with STEMI undergoing primary percutaneous coronary intervention

Smoker's paradox usually refers to the observation of a favorable outcome of smoking patients in acute myocardial infarction. From April 2006 to December 2018 a population of 2456 patients with ST segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI) were prospectively enrolled in the MATRIX registry. Ischemic time, clinical, demographics, angiographic data, and 1-year follow-up were collected. Among 2546 patients admitted with STEMI, 1007 (41 %) were current smokers. Smokers were 10 years younger and had lower crude in-hospital and 1-year mortality (1.5 % vs 6 %, p