Smoking is the dominating modifiable risk factor in younger patients with STEMI

Gleerup, H; Dahm, Christina C.; Thim, Troels; Jensen, Svend Eggert; Jensen, Lisette Okkels; Kristensen, Steen Dalby; Bøtker, Hans Erik; Mæng, Michael

doi:10.1177/2048872618810414

Cited by 10 publications

(8 citation statements)

References 22 publications

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“…Several previous studies have reported elevated risk of various cardiovascular diseases, especially that in young smokers. [4–7, 9, 12, 15, 16] In one study that reported the risk of smoking in patients with ST-elevation myocardial infarction (STEMI) according to age, the incidence of STEMI was 8.5 times higher in younger smokers, while that was only 3.1 times higher in smokers who were older than 65 years. [17] However, previous studies were mainly cross-sectional or observational studies which involves relatively small number of patients.…”

Section: Discussionmentioning

confidence: 99%

“…[17] However, previous studies were mainly cross-sectional or observational studies which involves relatively small number of patients. [12, 15, 16] Even in large cohort studies and meta-analyses, they usually focused on one or two diseases. [4, 5, 8] On the contrary, our study is a large cohort study which encompasses more than 500,000 participants over 10 years, and we investigated multiple cause of death and various diseases including cardiac death, non-cardiac death, acute myocardial infarction, sudden cardiac death, ischemic stroke and lung cancer.…”

Section: Discussionmentioning

confidence: 99%

“…Smokers tend to experience MI at an earlier age than do non-smokers, and smoking is more prevalent in young MI patients. [9–12]…”

Section: Introductionmentioning

confidence: 99%

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Differential impact of smoking on cardiac or non-cardiac death according to age

et al. 2019

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Tobacco smoking causes cardiovascular diseases, lung disease, and various cancers. Understanding the population-based characteristics associated with smoking and the cause of death is important to improve survival. This study sought to evaluate the differential impact of smoking on cardiac or non-cardiac death according to age. Data from 514,866 healthy adults who underwent national health screening in South Korea were analyzed. The participants were divided into three groups: never-smoker, ex-smoker or current smoker according to the smoking status. The incidence rates and hazard ratios (HRs) of cardiac or non-cardiac deaths according to smoking status and age groups during the 10-year follow-up were calculated to evaluate the differential risk of smoking. Over the follow-up period, 6,192 and 24,443 cardiac and non-cardiac deaths had occurred, respectively. The estimated incidence rate of cardiac and non-cardiac death gradually increased in older age groups and was higher in current smokers and ex-smokers than that in never-smokers among all age groups. After adjustment of covariates, the HRs for cardiac death of current smokers compared to never-smokers were the highest in individuals in their 40’s (1.82; 95% CI, 1.45–2.28); this gradually decreased to 0.96 (95% CI, 0.67–1.38) in individuals >80 years. In contrast, the HRs for non-cardiac death peaked in individuals in their 50’s, (HR 1.69, 95% CI 1.57–1.82) and was sustained in those >80 years (HR 1.40, 95% CI 1.17–1.69). Ex-smokers did not show elevated risk of cardiac death compared to never-smokers in any age group, whereas they showed significantly higher risk of non-cardiac death in their 60’s and 70’s (HR, 1.29; 95% CI, 1.19–1.39; HR 1.22, 95% CI, 1.12–1.32, respectively). Acute myocardial infarction and lung cancer showed patterns similar to those of cardiac and non-cardiac death, respectively. Smoking was associated with higher relative risk of cardiac death in the middle-aged group and non-cardiac death in the older age group. Ex-smokers in the older age group had elevated risk of non-cardiac death. To prevent early cardiac death and late non-cardiac death, smoking cessation should be emphasized as early as possible.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Differential impact of smoking on cardiac or non-cardiac death according to age

et al. 2019

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“…This could explain up to 10% of STEMI in females before the age of 50 [23]. Smoking is usually the sole risk factor in young females with acute myocardial infarction [9,24]. Therefore, the relation between smoking, coronary dissection and parietal hematoma should be investigated.…”

Section: Discussionmentioning

confidence: 99%

Evolution of ST-Elevation Acute Myocardial Infarction Prevalence by Gender Assessed Age Pyramid Analysis—The Piramyd Study

Loyeau¹,

Benamer

Bataille³

et al. 2018

JCM

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Introduction: Recent studies reported a decrease in the incidence of acute myocardial infarction. This favorable evolution does not extend to young women. The interaction between gender, risk factors and myocardial infarction incidence remains controversial. Objective: To compare the evolution of the age pyramid of patients with ST-elevation myocardial infarction (STEMI) according to gender. Methods: Data from patients with STEMI managed in pre-hospital settings prospectively collected in the greater Paris area. Evolution of patient demographics and risk factors was investigated. Results: 28,249 patients with STEMI were included in the registry between 2002 and 2014, 21,883 (77%) males and 6366 (23%) females. The sex ratio did not significantly vary over the study period (p = 0.4). Median patient age was 60.1 years (51.1–73.0) and was significantly different between males and females, respectively 57.9 (50.0–68.3) vs. 72.9 years (58.3–82.2) (p = 0.0004). The median age of males significantly (p = 0.0044) increased from 57.6 (50.1–70.0) in 2002 to 58.1 years (50.5–67.8) in 2014. The median age of females significantly (p = 0.0006) decreased from 73.7 (57.9–81.8) to 69.6 years (57.0–82.4). The median gap between the age of men and women significantly (p = 0.0002) decreased, from 16.1 to 11.5 years. Prevalence of risk factors was unchanged or decreased except for hypertension which significantly increased in males. The rate of STEMI without reported risk factors increased in both males and females. Conclusion: The age of STEMI onset significantly decreased in females, whereas it significantly increased in males. The prevalence of risk factors decreased in males, whereas no significant variation was found in females.

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“…Smoking is an important modifiable risk factor for the prevention of myocardial infarction. Analysis of patients with an ST-elevation myocardial infarction (STEMI) included in the Western Denmark Heart Registry shows that despite public information campaigns and general warnings, smoking remains the most prevalent modifiable risk factor in younger patients with STEMI (13).…”

Section: Issue @ a Glancementioning

confidence: 99%

Update on the emergency department diagnosis and risk stratification of acute chest pain

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2020

European Heart Journal: Acute Cardiovascular Care

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Smoking is the dominating modifiable risk factor in younger patients with STEMI

Cited by 10 publications

References 22 publications

Differential impact of smoking on cardiac or non-cardiac death according to age

Differential impact of smoking on cardiac or non-cardiac death according to age

Evolution of ST-Elevation Acute Myocardial Infarction Prevalence by Gender Assessed Age Pyramid Analysis—The Piramyd Study

Update on the emergency department diagnosis and risk stratification of acute chest pain

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