{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T19:52:47Z","timestamp":1793735567656,"version":"4.6.1"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2013,5,20]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Compared to those who never smoked, a paradoxical effect of smoking on reducing mortality in patients admitted with myocardial ischemia has been reported. We sought to determine if this effect was present in patients hospitalized with ischemic stroke.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Using the local Get with the Guidelines\u2010Stroke registry, we analyzed 4305 consecutively admitted ischemic stroke patients (March 2002\u2013December 2011). The sample was divided into smokers versus nonsmokers. The main outcome of interest was the overall inpatient mortality. Compared to nonsmokers, tobacco smokers were younger, more frequently male and presented with fewer stroke risk factors such as hypertension, hyperlipidemia, diabetes, coronary artery disease, and atrial fibrillation. Smokers also had a lower average NIH Stroke Scale (\n              <jats:styled-content style=\"fixed-case\">NIHSS<\/jats:styled-content>\n              ) and fewer received tissue plasminogen activator (\n              <jats:styled-content style=\"fixed-case\">tPA<\/jats:styled-content>\n              ). Patients in both groups had similar adherence to early antithrombotics, dysphagia screening prior to oral intake, and deep vein thrombosis (\n              <jats:styled-content style=\"fixed-case\">DVT<\/jats:styled-content>\n              ) prophylaxis. Smoking was associated with lower all\u2010cause in\u2010hospital mortality (6.6% versus 12.4%; unadjusted\n              <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n              0.46;\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              [0.34 to 0.63];\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). In multivariable analysis, adjusted for age, gender, ethnicity, hypertension, diabetes mellitus, hyperlipidemia,\n              <jats:styled-content style=\"fixed-case\">CAD<\/jats:styled-content>\n              , atrial fibrillation,\n              <jats:styled-content style=\"fixed-case\">NIHSS<\/jats:styled-content>\n              , and\n              <jats:styled-content style=\"fixed-case\">tPA<\/jats:styled-content>\n              , smoking remained independently associated with lower mortality (adjusted\n              <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\n              0.64;\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              [0.42 to 0.96];\n              <jats:italic>P<\/jats:italic>\n              =0.03).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Similar to myocardial ischemia, smoking was independently associated with lower inpatient mortality in acute ischemic stroke. This effect may be due to tobacco\u2010induced changes in cerebrovascular vasoreactivity, or may be due in part to residual confounding. Larger, multicenter studies are needed to confirm the finding and the effect on 30\u2010day and 1\u2010year mortality.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.113.000171","type":"journal-article","created":{"date-parts":[[2013,6,20]],"date-time":"2013-06-20T03:56:20Z","timestamp":1371700580000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":77,"title":["Paradoxical Association of Smoking With In\u2010Hospital Mortality Among Patients Admitted With Acute Ischemic Stroke"],"prefix":"10.1161","volume":"2","author":[{"given":"Syed F.","family":"Ali","sequence":"first","affiliation":[{"name":"Department of Neurology, Massachusetts General Hospital\/Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric E.","family":"Smith","sequence":"additional","affiliation":[{"name":"Calgary Stroke Program, University of Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepak L.","family":"Bhatt","sequence":"additional","affiliation":[{"name":"Brigham and Women's Hospital and VA Boston Healthcare System, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregg C.","family":"Fonarow","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Ronald Reagan\u2010UCLA Medical Center, Los Angeles, CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee H.","family":"Schwamm","sequence":"additional","affiliation":[{"name":"Department of Neurology, Massachusetts General Hospital\/Harvard Medical School, Boston, MA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","first-page":"7","article-title":"Short and long\u2010term prognostic indices in acute myocardial infarction. A study of 606 patients initially treated in a coronary care unit","volume":"555","author":"Helmers C","year":"1973","unstructured":"Helmers C. Short and long\u2010term prognostic indices in acute myocardial infarction. A study of 606 patients initially treated in a coronary care unit. 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Nicotine Tob Res. 2012;0:nts248v1\u2010nts248.","journal-title":"Nicotine Tob Res"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1681.2012.05721.x"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1186\/1741-7015-9-97"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(93)91125-2"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(95)00299-5"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.91.6.1659"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(96)00091-5"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ancard.2010.07.006"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000168163.72351.f3"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.91.2.298"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(96)00334-8"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.85.4.1254"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/ageing\/afm134"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.932822"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(00)00810-X"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.ATV.2.3.208"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/92.6.327"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(88)90645-X"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.STR.30.3.651"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.113.000171","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T09:59:31Z","timestamp":1715594371000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.113.000171"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,5,20]]},"references-count":30,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2013,5,20]]}},"alternative-id":["10.1161\/JAHA.113.000171"],"URL":"https:\/\/doi.org\/10.1161\/jaha.113.000171","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,5,20]]},"assertion":[{"value":"2013-03-28","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-05-15","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2013-06-19","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e000171"}}