IJCS | Volume 32, Nº2, May/June 2019

262 Albuquerque et al. Association smoking and alcohol consumption AMI Int J Cardiovasc Sci. 2019;32(3)261-268 Original Article Smoking cessation virtually benefits all smokers, regardless of age, duration or tobacco smoking load. A reduction in mortality rate is observed with smoking cessation at any age. 9 However, the sooner smoking cessation occurs, the greater the benefits: those who stop smoking by 40 years of age avoid 90% of the increased risk of death of continuing smoking. 10 Until this day, tobacco use is clearly present in society, despite numerous efforts of public policies andwarnings from the medical community about the harms that smoking causes to a person’s health. It is also known that alcohol is toxic for several organs and systems. However, light/moderate and regular alcohol consumption is a protective factor for coronary heart diseases, contributing with reduced AMI risk. In spite of their clear association with cardiovascular morbidity and mortality, there are still gaps concerning the association of these two factors with the severity and complexity of coronary injuries in patients with AMI. Thus, this study aims at assessing the relationship of smoking and alcohol consumption with the severity of coronary injuries in patients with AMI. Methods This was a cross-sectional, observational study carried out in the emergency units of public hospitals in the metropolitan region of Florianopolis, centers of reference in the treatment of patients with AMI, with a population composed by 226 patients seen in the emergency department for AMI, in the period of August 2016 to June 2017. The objectives of this study were to describe the demographic and clinical characteristics of the population; to associate these data with the severity (expressed by the left ventricular ejection fraction - LVEF) and complexity (measured by the SYNTAX score) of coronary injuries and with coronary perfusion after PCI in AMI patients, presenting with ST-segment elevation (assessed by TIMI frame count), and to correlate smoking, alcohol andwine consumption, using the SYNTAX score, LVEF and TFC. The patients were selected consecutively when admitted to the emergency, diagnosed with first AMI. We included patients over 18 years of age; of both sexes; with precordial pain suggestive of acute myocardial infarction associated with electrocardiogram with new ST segment elevation at the J point in two contiguous leads: ≥ 0.1 mV in all leads, except for leads V2 and V3, to which the limits of ≥ 0.2 mV in men ≥ 40 years, ≥ 0.25 mV in men < 40 years and ≥ 0.15 mV in women are applied, or presence of precordial pain suggestive of acute myocardial infarction associated with elevation in troponin I or CK-MB levels above the 99 th percentile of the upper reference limit. Patients with previous acute myocardial infarction were excluded. This study is an integral part of another ongoing study called Catarina Heart Study, a project entitled “Follow- up of patients after first acute MI in the state of Santa Catarina: A study of prospective cohort (Catarina Heart Study)”, with the general aim of assessing the mortality and severity of ischemic disease in patients with post- myocardial infarction and their potential protective and risk factors. The instrument of data collection used corresponds to that of Catarina Study. The Catarina Study was submitted and approved by the Committee of Ethics in Human Researches of ICSC (CEP-ICSC), via the Brazil Platform (Plataforma Brasil), and approved with opinion number 1519838. Statistical analysis We calculated a sample of 192 patients to find a mean difference of 2 points in the SYNTAX score, with a standard deviation of 7.0, power (80%), alpha (0.05), among alcohol consumer patients and non-alcohol consumers based on previous data from our group. The data were tabulated using the Windows Excel software and analyzed using the Statistical Package for the Social Sciences, version 13.0 (SPSS Inc., Chicago, IL, USA, 2005) forWindows. Qualitative datawere presented as simple and relative frequencies and assessed using the Chi-square test. Data normalitywas assessed through the Kolmogorov-Smirnov test. Quantitative datawith normal distribution were expressed as mean and standard deviation and assessed using the t test for independent samples. Non-normal quantitative data were described as median and interquartile amplitude and assessed using the Mann-Whitney U test. Correlations were assessed using Kendall›s correlation coefficients, since in all evaluations at least one of the variables presented non-normal distribution. P-values less than 0.05 were considered statistically significant. Results From 2016 to 2017, we analyzed the data of 226 patients who participated of the Catarina Heart Study, admitted to public hospitals of the metropolitan region of Florianopolis, due to AMI.