De Luca, GiuseppeAlgowhary, MagdyUguz, BeratOliveira, Dinaldo C.Ganyukov, VladimirZimbakov, ZanCercek, MihaJensen, Lisette OkkelsLoh, Poay HuanCalmac, LucianFerrer, Gerard Roura i.Quadros, AlexandreMilewski, MarekScotto D’Uccio, Fortunatovon Birgelen, ClemensVersaci, FrancescoTen Berg, JurrienCasella, GianniWong Sung Lung, AaronKala, PetrDíez Gil, José LuisCarrillo, XavierDirksen, MauritsBecerra-Munoz, Victor M.Lee, Michael Kang yinJuzar, Dafsah ArifaJoaquim, Rodrigo de MouraPaladino, RobertoMilicic, DavorDavlouros, PeriklisBakraceski, NikolaZilio, FilippoDonazzan, LucaKraaijeveld, AdriaanGalasso, GennaroArpad, LuxLucia, MarinucciVincenzo, GuiducciMenichelli, MaurizioScoccia, AlessandraYamac, Aylin HaticeUgur Mert, KadirFlores Rios, XacobeKovarnik, TomasKidawa, MichalMoreu, JosèVincent, FlavienFabris, EnricoMartínez-Luengas, Iñigo LozanoBoccalatte, MarcoBosa Ojeda, FranciscoArellano-Serrano, CarlosCaiazzo, GianlucaCirrincione, GiuseppeKao, Hsien LiSanchis Forés, JuanVignali, LuigiPereira, HelderManzo, StephaneOrdoñez, SantiagoÖzkan, Alev AratScheller, BrunoLehtola, HeidiTeles, RuiMantis, ChristosAntti, YlitaloSilveira, João António BrumZoni, RodrigoBessonov, IvanSavonitto, StefanoKochiadakis, GeorgeAlexopulos, DimitriosUribe, Carlos E.Kanakakis, JohnFaurie, BenjaminGabrielli, GabrieleBarrios, Alejandro GutierrezBachini, Juan PabloRocha, AlexTam, Frankie Chor CheungRodriguez, AlfredoLukito, Antonia AnnaSaint-Joy, VeauthyelauPessah, GustavoTuccillo, AndreaCortese, GiulianaParodi, GuidoBouraghda, Mohamed AbedKedhi, ElvinLamelas, PabloSuryapranata, HarryNardin, MatteoVerdoia, Monica2022-11-302022-11-302022-112077-0383PURE: 47974037PURE UUID: 043977d2-07a2-409e-87ea-317def53013dScopus: 85142347154PubMed: 36431198http://hdl.handle.net/10362/145919Publisher Copyright: © 2022 by the authors.The so-called “smoking paradox”, conditioning lower mortality in smokers among STEMI patients, has seldom been addressed in the settings of modern primary PCI protocols. The ISACS–STEMI COVID-19 is a large-scale retrospective multicenter registry addressing in-hospital mortality, reperfusion, and 30-day mortality among primary PCI patients in the era of the COVID-19 pandemic. Among the 16,083 STEMI patients, 6819 (42.3%) patients were active smokers, 2099 (13.1%) previous smokers, and 7165 (44.6%) non-smokers. Despite the impaired preprocedural recanalization (p < 0.001), active smokers had a significantly better postprocedural TIMI flow compared with non-smokers (p < 0.001); this was confirmed after adjustment for all baseline and procedural confounders, and the propensity score. Active smokers had a significantly lower in-hospital (p < 0.001) and 30-day (p < 0.001) mortality compared with non-smokers and previous smokers; this was confirmed after adjustment for all baseline and procedural confounders, and the propensity score. In conclusion, in our population, active smoking was significantly associated with improved epicardial recanalization and lower in-hospital and 30-day mortality compared with previous and non-smoking history.1150638engCOVID-19myocardial infarctionpercutaneous coronary interventionsmoking paradoxGeneral Medicinejournal article10.3390/jcm11226722https://www.scopus.com/pages/publications/85142347154