Panagiotakos Demosthenes B, Rallidis Loukianos S, Pitsavos Christos, Stefanadis Christodoulos, Kremastinos Dimitrios
Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.
Int J Cardiol. 2007 Apr 4;116(3):371-5. doi: 10.1016/j.ijcard.2006.04.051. Epub 2006 Jul 14.
The effect of cigarette smoking on the risk of myocardial infarction (MI) has long been investigated. However, its role on the likelihood of having MI at young age has not been well understood and appreciated. We investigated whether smoking habits can discriminate young individuals with MI from age- and sex-matched controls.
We enrolled 100 consecutive patients who had survived their first episode of MI before the age of 36 years and 100 age- and sex-matched controls without a history of cardiovascular disease. Smoking habits, physical activity status, body mass index and blood lipids levels were measured in all participants.
96% of the patients with premature MI and 55% of the controls reported current smoking habits (p<0.001). Moreover, patients had higher levels of total cholesterol, low density lipoprotein cholesterol, triglycerides and lower levels of high density lipoprotein cholesterol (p<0.05). Multivariate logistic regression analysis showed that current smoking increased 6-fold the odds of having a MI (95% CI 1.01 to 37), after controlling for age, sex, body mass index, hypertension, diabetes, physical activity, family history of coronary heart disease and total cholesterol levels. Finally, discriminant analysis showed that pack-years of smoking was the strongest discriminator for MI among all the investigated factors (lambda-Wilks=0.85).
Our study suggests that cigarette smoking seems to play the most important role for having a MI in individuals under the age of 36 years.
吸烟对心肌梗死（MI）风险的影响长期以来一直受到研究。然而，其在年轻时发生MI可能性方面的作用尚未得到充分理解和重视。我们调查了吸烟习惯是否能区分年轻的MI患者与年龄和性别匹配的对照组。
我们招募了100例在36岁之前首次发生MI且存活下来的连续患者，以及100例年龄和性别匹配、无心血管疾病史的对照组。测量了所有参与者的吸烟习惯、身体活动状况、体重指数和血脂水平。
96%的早发性MI患者和55%的对照组报告有当前吸烟习惯（p<0.001）。此外，患者的总胆固醇、低密度脂蛋白胆固醇、甘油三酯水平较高，高密度脂蛋白胆固醇水平较低（p<0.05）。多变量逻辑回归分析显示，在控制了年龄、性别、体重指数、高血压、糖尿病、身体活动、冠心病家族史和总胆固醇水平后，当前吸烟使发生MI的几率增加了6倍（95%可信区间1.01至37）。最后，判别分析表明，在所有调查因素中，吸烟包年数是MI最强的判别因素（lambda-Wilks=0.85）。
我们的研究表明，吸烟似乎在36岁以下个体发生MI方面起着最重要的作用。
