Division Lillehammer, Department of Medicine, Innlandet Hospital Trust, Lillehammer, Norway.
Int J Cardiol. 2013 Sep 10;167(6):2792-7. doi: 10.1016/j.ijcard.2012.07.010. Epub 2012 Aug 17.
The aim was to investigate possible gender differences in the years of life lost after acute myocardial infarction (MI) and to explore how smoking affects life expectancy in the two genders.
In the years 1998-2005, 2281 patients (36.8% women) who were discharged from or died in hospital following a diagnosis of MI were included. Survivors were followed for a mean of 8 years. The age of death for each patient was subtracted from the average projected age of death for individuals in the general population with a similar age to the patient at the time of their MI. The effects of gender, smoking, and other risk factors on the years of life lost were analysed.
During follow-up, 55% of the patients died. Non-smokers, ex-smokers and current smokers lost 5.4, 6.4 and 10.3 years of life, respectively. Structural equation modeling showed that currently smoking men lost 4.2 more years more than did non-smoking men (P<0.001), and this was mediated through more prematurely occurring MIs. Female current smokers lost 1.9 years more than male current smokers and female ex-smokers lost 1.8 years more than male ex-smokers (both P<0.001).
MI caused a substantial number of years of life lost, with a heavier loss in current smokers than in ex-smokers and non-smokers. The effect was predominantly related to the patient's age at the event. More years of life were lost among smoking women than among smoking men, indicating that smoking is most detrimental for the female gender.
本研究旨在探讨急性心肌梗死（MI）后患者生命损失年数的性别差异，并探讨吸烟对两性预期寿命的影响。
1998 年至 2005 年期间，共纳入 2281 例（36.8%为女性）出院或住院后因 MI 死亡的患者。对存活者进行了平均 8 年的随访。每位患者的死亡年龄减去与患者 MI 时年龄相似的一般人群中个体预期死亡年龄的差值即为生命损失年数。分析了性别、吸烟及其他危险因素对生命损失年数的影响。
随访期间，55%的患者死亡。不吸烟者、曾经吸烟者和现在吸烟者分别损失了 5.4、6.4 和 10.3 年的预期寿命。结构方程模型显示，现在吸烟的男性比不吸烟的男性多损失了 4.2 年（P<0.001），这主要是由于更年轻的患者发生 MI 所致。女性现在吸烟者比男性现在吸烟者多损失了 1.9 年，女性曾经吸烟者比男性曾经吸烟者多损失了 1.8 年（均 P<0.001）。
MI 导致大量的生命损失年数，现在吸烟者比曾经吸烟者和不吸烟者的损失更大。这种影响主要与患者发病时的年龄有关。吸烟女性比吸烟男性损失了更多的生命年数，表明吸烟对女性的危害最大。
