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Background and Objectives: Cigarette smoking has been recognized as a prominent threat to women’s health. We investigated the impactof smoking on clinical outcomes in Korean female patients after acute myocardial infarction (AMI). Subjects and Methods: Out of the AMI patients who enrolled in the Korea AMI Registry, 4444 female patients were included in this study. Patients were divided into two groups–non-smoker and smoker–according to their current smoking status. We compared in-hospital mortalityand major adverse cardiac events (MACE), including cardiac death, myocardial infarction, repeated percutaneous coronary intervention(PCI), or coronary artery bypass grafting during the one-year clinical follow-up period between two groups. Results: The non-smoker group had more hypertension (HTN) and diabetes mellitus. The levels of total cholesterol, triglyceride, and lowdensitylipoprotein cholesterol were higher in the non-smoker group. However, in-hospital mortality was significantly higher in the smokergroup (1.0% vs. 2.4%, p=0.002), and cardiac death during the 12-month clinical follow-up was significantly more frequent in the smokergroup (2.2% vs. 4.5%, p=0.003). Total MACEs during the 12 months were higher in the smoker group (4.9% vs. 6.8%, p=0.014). Smokingand HTN were independent predictors of MACE {odds ratio (OR): 1.742, 95% confidence interval (CI): 1.010–3.000, p=0.046; OR: 1.573,95% CI: 1.003–2.466, p=0.049, respectively}. Conclusion: Female smokers with AMI showed significantly higher in-hospital mortality and MACE rates during the one-year clinical follow-up period.

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