Parisa Janjani, Sayeh Motevaseli, Nader Asgari, Mohammad Rouzbahani, Hosna Janjani, Atiyeh Asadmobini, Nahid Salehi
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.