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Smoking, a strong risk factor for ST-segment elevation myocardial infarction has declined in prevalence in the US in recent years. The incidence of STEMI has also declined. The importance of smoking as a risk factor for STEMI in contemporary practice remains unknown.
Our study included all patients who presented with new onset STEMI and underwent primary PCI across 44 hospitals in Michigan from January 2010 to March 2012. Overall and age-stratified odds ratios (OR) were calculated by comparing smoking rates in the study population to the expected smoking rates for the general population. Estimated ORs and PCI prevalence were used to estimate the number of active smokers needed to quit to prevent one STEMI and the number and percent of STEMIs expected to be prevented annually in Michigan at various assumed quit rates.
Of 6,892 patients who underwent primary PCI for their first STEMI during the study period, smoking was reported by 46.43%. Patients undergoing PCI were more likely to be smokers (OR of 3.4, 95% confidence interval: 3.3–3.4) with higher odds of smoking in the young (OR for age < 35 years 11.4, 95% CI 10.0–12.8). Relative smoking reductions of 10, 50, and 75%, are expected to prevent 109, 544, and 815 STEMIs annually in Michigan.
Smoking is a powerful risk factor for STEMI in contemporary practice especially for the young. Smoking cessation, especially among younger adults is likely to be a powerful and effective public health strategy for primary prevention of STEMI.
Poster Sessions, Expo North
Monday, March 11, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Acute Coronary Syndromes: Clinical Outcomes
Abstract Category: 1. Acute Coronary Syndromes: Clinical
Presentation Number: 1299-183
- 2013 American College of Cardiology Foundation