Scientists from Hospital Lariboisiere in France found that the risk of death or poor prognosis after a heart attack is more than 20-fold higher in smokers with exhaled carbon monoxide levels above 13 ppm, indicating heavy smoking and inhalation of smoke.
The combustion of cigarettes produces carbon monoxide, a highly toxic gas also found in motor vehicle exhaust, pollution, and malfunctioning furnaces.
Carbon monoxide takes the place of oxygen in the blood and can be lethal.
The team says that patients with heart attacks have insufficient oxygen in their coronary arteries. If part of the oxygen was replaced by carbon monoxide, the event could be more severe.
In the study, the team examined 1,379 patients. 720 (52%) patients had the acute coronary syndrome, 186 (13%) had acute heart failure, and 473 (34%) had other heart conditions.
One-third of participants (33%) were non-smokers, 39% were former smokers, and 27% were active smokers.
Carbon monoxide level was similar in non-smokers and former smokers (mean 3.6 and 3.3 ppm, respectively) and much higher in active smokers (mean 9.9 ppm).
The team found carbon monoxide level was strongly linked to adverse events in active smokers, meaning that for every one ppm increase in carbon monoxide there was a 14% higher risk of disease.
The researchers identified 13 ppm as the best threshold for predicting a worse prognosis. The odds of a major adverse event were 23-fold higher in smokers with a carbon monoxide level above 13 ppm.
In smokers with a carbon monoxide level of 13 ppm or below, the risk of heart disease events was similar to non or former smokers.
Nearly one in five (19%) active smokers had a carbon monoxide level above 13 ppm compared with less than 2% of non or former smokers.
The shows that when a smoker is hospitalized for an acute cardiac event, a carbon monoxide level above 13 ppm is associated with a worse prognosis.
In addition, the level of carbon monoxide was a much more powerful predictor of adverse events than smoking status.
If you care about smoking, please read studies about smoking may increase heart disease risk by 200% and e-cigarette smoke may cause lung cancer and bladder disease.
For more information about smoking, please see recent studies about the cause of weight gain after smoking cessation, and scientists find silent sleep danger for smokers
The research was presented at ESC Congress 2022 and conducted by Professor Patrick Henry et al.
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