Comparison of mortality rates after acute myocardial infarction in smokers versus nonsmokers

According to several reports, patients who smoke paradoxically have favorable outcomes after acute myocardial infarctions (AMIs) compared with nonsmokers. The Optimal Trial in Myocardial Infarction With the Angiotensin 11 Antagonist Losartan evaluated 5,477 high-risk patients after AMIs. Patients with a history of smoking had a 17% smaller risk for death (hazard ratio 0.83, p = 0.005) compared with nonsmokers. After adjustment for age only, without correction for other co-morbidities or risk factors, the lower all-cause mortality in smoker population was explained by the smokers' generally younger age, with better prognoses due to their age. (C) 2004 by Excerpta Medica, Inc.