Clinical characteristics determining the mode of presentation in patients with acute coronary syndromes

Abstract

The clinical presentation of acute coronary syndromes may be influenced by various factors that have the potential to influence the coagulability of the blood, the collateralization of the coronary circulation and myocardial mass. Myocardial infarction is favored by cigarette smoking, advanced age and renal impairment, while unstable angina is favored by treatment with aspirin, hypertension, previous revascularization and previous coronary syndromes.

Cigarette smoking and acute coronary syndromes: A multinational observational study

“…Smokers have a heightened thrombotic response. Therefore, as observed here, proportionally fewer smokers present with non-STsegment elevation acute coronary syndromes [18].…”

“…Indeed, it has already been reported that smoking is associated with ST-segment elevation among patients admitted with acute coronary syndromes [18,19]. In the setting of ST-segment elevation myocardial infarction, a fibrin-rich thrombus produces a stable clot, which leads to complete and sustained coronary occlusion.…”

Smoking, Oxidative Stress and Cardiovascular Diseases-Do Anti-Oxidative Therapies Fail?

“…We can list four typical clinical situations. First, cigarette smokers have a significantly increased risk of acute coronary syndrome [49] and a high likelihood of developing thrombosis [50]. The increased thrombotic tendency observed in smokers might be the basis of acute coronary syndromes in them.…”

Effect of Smoking Status on Clinical Outcome and Efficacy of Clopidogrel in Acute Coronary Syndrome

“…This is consistent with past reports and is believed to be related to the heightened thrombotic response of smokers. 7,18, 19 Smokers have lower rates of other risk factors of coronary artery disease, such as diabetes mellitus, hypertension, and CKD. 20 Smokers with ACS present an average of 8 years earlier with fewer risk factors and a lower incidence of multivessel disease, in agreement with past reports.…”