Gramenzi A, Gentile A, Fasoli M, D'Avanzo B, Negri E, Parazzini F, La Vecchia C
Istituto di Ricerche Farmacologiche Mario Negri, Milano.
G Ital Cardiol. 1989 Jan;19(1):82-8.
We evaluated the relation between smoking and myocardial infarction using data from a hospital-based case-control study conducted in Northern Italy on 262 young and middle-age women with acute myocardial infarction (median age: 49 years) and 519 controls (median age: 47 years), admitted for a series of acute conditions unrelated to any of the established or potential risk factors for ischaemic heart disease. With reference to lifelong non-smokers, the multivariate relative risk was not significantly higher for ex-smokers, but rose progressively with the number of cigarettes smoked. The risk estimates were 2.3, 5.9 and 11.0 for less than 15, 15-24, greater than or equal to 25 cigarettes per day. This trend in risk was statistically significant. Smoking-related risks were similar below and above 50 years of age; they were consistently and substantially higher in various strata of other major determinants of myocardial infarction (hyperlipidaemia, hypertension) or correlated lifestyle habits (alcohol and coffee). In terms of population attributable risk, 48% of all myocardial infarction in this data could be attributed to smoking. Although myocardial infarction is less frequent in Italian women compared to Northern European or American women, our data indicate that cigarette smoking is undoubtedly its most prominent cause. This confirms, once again, the urgent need to intervene and eliminate this risk factor.
我们利用在意大利北部开展的一项基于医院的病例对照研究数据，评估吸烟与心肌梗死之间的关系。该研究纳入了262名患有急性心肌梗死的年轻及中年女性（中位年龄：49岁）和519名对照者（中位年龄：47岁），这些对照者因一系列与缺血性心脏病的任何既定或潜在危险因素无关的急性病症入院。与终生不吸烟者相比，既往吸烟者的多变量相对风险并无显著升高，但随着吸烟量的增加而逐渐上升。每天吸烟少于15支、15 - 24支、大于或等于25支的风险估计值分别为2.3、5.9和11.0。这种风险趋势具有统计学意义。50岁以下和50岁以上人群中与吸烟相关的风险相似；在心肌梗死的其他主要决定因素（高脂血症、高血压）或相关生活方式习惯（饮酒和喝咖啡）的各个分层中，吸烟相关风险始终且显著更高。就人群归因风险而言，该数据中所有心肌梗死病例的48%可归因于吸烟。尽管与北欧或美国女性相比，意大利女性心肌梗死的发病率较低，但我们的数据表明，吸烟无疑是其最主要的病因。这再次证实了迫切需要采取干预措施并消除这一危险因素。
