- Young women (ages 18-49 years) have a “striking” increase in risk for ST-elevation myocardial infarction (STEMI) if they smoke, by more than 13-fold.
Why this matters
- Although smoking is well known for its role in STEMI risk, this study uncovers a strong age and sex effect.
- Editorial: clinicians need to engage better with patients about smoking cessation.
- Peak STEMI rates were in 70-79-year and 50-59-year age ranges for women (235 per 100,000 patient-years) and men (425 per 100,000 patient-years), respectively.
- Women who smoked had higher STEMI risk increase vs men who smoked (both compared with nonsmokers):
- Incidence rate ratio (IRR), women: 6.62 (95% CI, 5.98-7.31).
- IRR, men: 4.40 (95% CI, 4.15-4.67).
- Women aged 18-49 years had the greatest increase:
- IRR: 13.22 (95% CI, 10.35-16.66).
- The greatest difference by age and sex was for those ages 50-64 years:
- Women, IRR: 9.66 (95% CI, 8.30-11.18).
- Men, IRR: 4.47 (95% CI, 4.10-4.86).
- Even the involved artery differed by sex, likelier to be the right coronary artery in women vs men.
- Retrospective cohort study, patients attending a UK tertiary cardiothoracic center, 2009-2014, with acute STEMI (3343 STEMIs; 27.3% women).
- Funding: None disclosed.
- No information about smoking duration, quantity.