Department of Cardiology, Aarhus University Hospital, Denmark.
Department of Public Health, Aarhus University, Denmark.
Eur Heart J Acute Cardiovasc Care. 2020 Feb;9(1):70-75. doi: 10.1177/2048872618810414. Epub 2018 Nov 2.
Smoking is an important modifiable risk factor for myocardial infarction. It is unclear whether smoking habits at the time of an incident ST-segment elevation myocardial infarction (STEMI) differ across age groups and sex.
We included patients with incident STEMI registered in the Western Denmark Heart Registry from 2005 to 2015 (=9914). Patients were divided into four age groups (30-49, 50-59, 60-69 and ⩾70 years) with the latter serving as reference. Smoking was the most prevalent modifiable risk factor in 30-49-year-old patients (74% vs. hypertension 15%, hyperlipidaemia 10% and diabetes 7%). The smoking prevalence decreased with increasing age, while treatment for hypertension, hyperlipidaemia and diabetes increased with increasing age. Smoking was five times (odds ratio (OR) 5.15; 95% confidence interval (CI) 4.37-6.07) more prevalent among 30-49-year-old patients with STEMI than the reference group. Differences according to sex were significant as the OR for current smoking in women was 9.88 (95% CI 6.94-14.08) compared to OR 3.78 (95% CI 3.12-4.58) in men.
Despite public information campaigns and general warnings, smoking remains the most prevalent modifiable risk factor in younger patients with STEMI.
吸烟是心肌梗死的一个重要可改变的危险因素。目前尚不清楚在发生 ST 段抬高型心肌梗死（STEMI）时，吸烟习惯是否因年龄组和性别而异。
我们纳入了 2005 年至 2015 年期间在丹麦西部心脏注册中心登记的新发 STEMI 患者（n=9914）。患者被分为四个年龄组（30-49 岁、50-59 岁、60-69 岁和≥70 岁），后者作为参照。在 30-49 岁的患者中，吸烟是最常见的可改变危险因素（74% vs. 高血压 15%、高脂血症 10%和糖尿病 7%）。随着年龄的增长，吸烟的流行率逐渐降低，而高血压、高脂血症和糖尿病的治疗率则随着年龄的增长而增加。与参照组相比，30-49 岁的 STEMI 患者吸烟的比例高出五倍（比值比（OR）5.15；95%置信区间（CI）4.37-6.07）。性别差异显著，女性的当前吸烟 OR 为 9.88（95%CI 6.94-14.08），而男性的 OR 为 3.78（95%CI 3.12-4.58）。
尽管有公共信息宣传和一般警告，吸烟仍然是年轻 STEMI 患者中最常见的可改变危险因素。
