Sulo Gerhard, Burazeri Genc, Dehghan Abbas, Kark Jeremy D
Faculty of Medicine, Rr. Dibres No. 371, Tirana, Albania.
Croat Med J. 2008 Dec;49(6):751-6. doi: 10.3325/cmj.2008.49.751.
To assess the association between partners' smoking status and acute coronary syndrome in never smokers in Albania.
This population-based case-control study was conducted in Tirana in the period 2003-2006. It involved 467 consecutive patients with non-fatal acute coronary syndrome and 737 controls. Only married never-smokers (169 patients with acute coronary syndrome and 323 controls) were included in the analysis. Information on socioeconomic status, coronary risk factors, and partners' current smoking status was obtained by a structured questionnaire. Multivariate logistic regression was used to assess the association between partner's smoking status and acute coronary syndrome.
Among patients with acute coronary syndrome, 49% of women and 25% of men had a partner who was a current smoker, as opposed to 44% of women and 16% of men in the control group. In age-adjusted models, non-smoking men with smoking partners had a greater acute coronary syndrome risk (odds ratio [OR], 1.76; 95% confidence interval [CI], 0.98-3.18), while no association was found in women with smoking partners (OR, 1.05; 95% CI, 0.48-2.30). After adjustment for socioeconomic characteristics, coronary risk factors, and psychosocial factors, the acute coronary syndrome risk in men was somewhat lower (1.68; 95% CI, 0.81-3.47), while for women it was somewhat greater but still non-significant (1.19; 95% CI, 0.25-5.64). Sex-pooled estimate of the risk was OR 1.64 (95% CI, 0.96-2.83).
Partner's current smoking status was positively associated with a greater acute coronary syndrome risk in men but not in women, both before and after adjustment for socioeconomic characteristics and coronary risk factors. Programs aimed at reducing the exposure to passive smoking are need in countries with high prevalence of active smoking.
评估阿尔巴尼亚从不吸烟人群中伴侣吸烟状况与急性冠脉综合征之间的关联。
这项基于人群的病例对照研究于2003年至2006年期间在地拉那进行。研究纳入了467例非致命性急性冠脉综合征患者及737例对照。分析仅纳入已婚的从不吸烟者（169例急性冠脉综合征患者及323例对照）。通过结构化问卷获取社会经济状况、冠心病危险因素及伴侣当前吸烟状况等信息。采用多因素逻辑回归评估伴侣吸烟状况与急性冠脉综合征之间的关联。
在急性冠脉综合征患者中，49%的女性和25%的男性伴侣为当前吸烟者，而对照组中这一比例分别为44%的女性和16%的男性。在年龄调整模型中，有吸烟伴侣的不吸烟男性发生急性冠脉综合征的风险更高（比值比[OR]，1.76；95%置信区间[CI]，0.98 - 3.18），而有吸烟伴侣的女性未发现关联（OR，1.05；95% CI，0.48 - 2.30）。在对社会经济特征、冠心病危险因素及心理社会因素进行调整后，男性急性冠脉综合征风险有所降低（1.68；95% CI，0.81 - 3.47），而女性风险有所升高但仍无统计学意义（1.19；95% CI，0.25 - 5.64）。合并性别后的风险估计值为OR 1.64（95% CI，0.96 - 2.83）。
无论在调整社会经济特征和冠心病危险因素之前还是之后，伴侣当前吸烟状况与男性较高的急性冠脉综合征风险呈正相关，而与女性无关。在主动吸烟率较高的国家，需要开展旨在减少被动吸烟暴露的项目。
