Smoking and Acute Coronary Syndrome in Albania: Implications for Diagnosis, Management, and In-Hospital Outcomes

Abstract

Introduction: Tobacco use has numerous impacts on the cardiovascular system, which play a significant role in the development of cardiovascular disease (CVD).
Aim:To assess the influence of smoking cigarettes on the diagnosis, management, and in-hospital results of individuals admitted with various acute coronary syndromes (ACS).
Material and methods:In this retrospective study a total of 144 ACS smoker patients and 248 non-smoker patients, identified on the basis of their primary discharge diagnosis, were admitted to the cardiologyunit at Elbasan Regional Hospital in 2022-2023.Sociodemographic, clinical, and biochemical data, along with in-hospital outcomes, were compared. Multivariate logistic regression assessed predictors of adverse events, adjusting for potential confounders.
Results: The mean age of the smokers was significantly younger (64.3 ±10.1years) compared to the non-smokers (69.4 ±11.6 years) (p<0.001).Men were predominant among the smokers (71.5%) compared to 55.2% in the non-smoking patients (p<0.001).Smoking was associated with dyslipidemia (p=0.001), renal insufficiency (p=0.02) and a higher rate of critical cardiac symptoms (p=0.02)and increased levels of myocardial injury markers at admission (p=0.03). ACS type ST-Elevation Myocardial Infarction (STEMI) was more frequent among the smokers. In-hospital all-cause mortality was higher among smokers (p=0.001). Also, smoking is a significant predictor of overall ACS at admission OR=1.26 (1.08 - 2.12)(p=0.03), and in-hospital outcomeOR=1.8 (1.1 - 3.53) (p=0.03).
Conclusion: Smoking accelerates ACS onset and worsens in-hospital outcomes. These findings underscore the need for robust smoking cessation programs and tailored public health strategies.