IJCS | Volume 32, Nº2, May/June 2019

DOI: 10.5935/2359-4802.20190007 261 ORIGINAL ARTICLE International Journal of Cardiovascular Sciences. 2019;32(3)261-268 Mailing Address: Luis Gustavo Albuquerque Universidade do Sul de Santa Catarina (UNISUL), Av. Pedra Branca, 25, Cidade Universitária. Postal Code: 88137-270, Palhoça, Santa Catarina - Brazil. E-mail: lgalbuquerque.15@gmail.com Association between Smoking and Alcohol Consumption and the Severity of Coronary Artery Injuries in Patients with AMI Luis Gustavo Albuquerque, 1 D aniel Medeiros Moreira, 1, 2 R oberto Léo da Silva, 2 T ammuz Fattah 2 Universidade do Sul de Santa Catarina (UNISUL), 1 Palhoça, SC - Brazil Instituto de Cardiologia de Santa Catarina (ICSC), 2 São José, SC - Brazil Manuscript received January 25, 2018; revised manuscript August 16, 2018; accepted August 17, 2018. Abstract Background: Smoking is the most important risk factor for coronary heart disease (CHD) and ischemic events; alcohol consumption, on the other hand, appears to have a protective role. Objective: Assess the association between smoking and alcohol consumption with the severity of coronary artery injuries in patients with acute myocardial infarction (AMI). Methods: Cross-sectional study, performed in Santa Catarina. Variables were evaluated using the Chi-squared T/ Fisher’s exact test, Kendall’s correlation coefficient, Student’s t test or Mann-Whitney U test. Values of p < 0.05 were considered significant. Results: Between August 2016 to June 2017, 226 patients were evaluated with first episode of AMI. There was a difference in sex distribution, showing that 59.7% of men and 85.4% of women were not alcoholic (p < 0.001). There was a higher prevalence of non-hypertensive patients who consumed alcohol than hypertensive ones (40.7% vs. 24.4% and p = 0.010) and patients without diabetes who had drinking habits than those diabetic (36.4% vs. 12.0% and p = 0.001). There was also a higher prevalence of non-diabetic patients who smoked than diabetic ones (38.1% vs. 22.0% and p = 0.035). A weak and negative correlation was found between the number of cigarettes per day and the pack-year with the TIMI frame count (r = -0.174 and p = 0.041 and r = -0.192 and p = 0.027, respectively). The other associations did not show statistical significance. Conclusion: The study showed that the number of cigarettes consumed per day and the pack-year is related to a smaller TIMI frame count, i.e., to a better coronary flow, which may be related to the Smoker’s Paradox. There was no correlation between the beverage type and quantity with the SYNTAX score, Ejection fraction and TIMI frame count. (Int J Cardiovasc Sci. 2019;32(3)261-268) Keywords: Coronary Artery Disease Myocardial Infarction, Alcohol Drinking; Tobacco Use Disorder; Risk Factors. Introduction Coronary artery disease (CAD) is the leading cause of morbidity andmortalityworldwide. 1 Every year in Brazil, cardiovascular diseases account for more than one-third of deaths. 2 CAD is a chronic disease that progresses over a period of years or decades 3 and results in major social impact. Acute Myocardial Infarction (AMI) is one of the main and often the first manifestation of CAD. Protective and risk factors for CAD and AMI are widely known in the literature. Several studies indicate that mild-to-moderate alcohol consumption is associated with a 40 to 70% decreased risk of CAD, compared to no alcohol consumption or heavy alcohol use. 4 This decreased risk is found in both men and women, 5 and this protective effect has been observed in various groups. 6 Smoking, on the other hand, is the most important isolated risk factor – following advanced age – for coronary artery disease. Coronary ischemic events are the cause of death in more than one-third of these patients. 7 It is undoubtedly the most relevant preventable risk factor of cardiovascular disease. 8