Association between smoking burden and one-year mortality in ST-elevation and non-ST-elevation myocardial infarction: insights from a regional cohort

Cigarette smoking is a major modifiable risk factor for cardiovascular disease and acute myocardial infarction (MI). The prognostic impact of cumulative smoking exposure (pack-years) on post-MI outcomes remains uncertain. The controversial "smoker's paradox" suggesting better short-term prognosis in smokers has been largely attributed to younger age and fewer comorbidities. Prior studies frequently failed to quantify smoking intensity, stratify by MI subtype (STEMI vs. NSTEMI), or adequately adjust for confounders such as age and renal function.