Acute myocardial infarction in men and women - different impact of smoking in the two genders. : Analyses of a cohort study of 2281 patients admitted to hospital

摘要

It has been known for many years that smoking is a risk factor for myocardial infarction (MI). However, whether there are gender differences in the effects of smoking, implying that smoking is more harmful in women than in men has been debated but not settled. In the first half of the twentieth century men were hugely overrepresented among smokers in the Western world. As the occurrence of diseases caused by smoking became increasingly apparent, fewer men started smoking and more men gave up the habit, but this was not the case to the same extent in women. Altogether, smoking habits have changed substantially in Western civilizations during the last 20 years and this has also occurred in Norway, where smoking became about equally common in men and women from the early 1990s. Therefore we hoped that the present project with recently collected data could contribute to an improved understanding of the relationship between smoking and patients admitted to hospital with MI in the two genders.The previous decade would be an appropriate period in which to collect clinical data that, could supplement the standard risk analysis of the smoking and gender issue based on population studies. Furthermore, the standardization of diagnosing and medical treatment of patients with MI represents a particularly suitable background for new investigations on this topic. Thus, the study explores information on patients diagnosed with MI in the hospital in Lillehammer. The data were entered consecutively into a database during the eight years from 1998 to 2005 and with further follow-up of mortality until September 2010.It is the intention that this study will provide some of knowledge about MI in relation to smoking and gender. It is possible that this information may enable health workers and policy makers to evaluate whether there is a need for different policies and preventive measures in men and women.List of papers. Papers I and II are removed from the thesis due to copyright restrictions.Paper I Grundtvig M, Hagen TP, German M, Reikvam A. Sex-based differences in premature first myocardial infarction caused by smoking: twice as many years lost by women as by men. Eur J Cardiovasc Prev Rehabil 2009;16:174-9.Paper II Grundtvig M, Hagen TP, Amrud ES, Reikvam A. Mortality after Myocardial Infarction: impact of gender and smoking status. Eur J Epidemiol 2011;26:385-393.Paper III Grundtvig M, Hagen TP, Amrud ES, Reikvam A. Reduced life expectancy after myocardial infarction - smoking is more harmful for women than men. NOTICE: this is the author’s version of a work that was accepted for publication in Atherosclerosis. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in:Int J Cardiol. 2012 Aug 16. [Epub ahead of print]