吸烟引起的早发首次心肌梗死的性别差异
2009/07/30
目的：探讨吸烟是否在男女不同性别中影响首次心肌梗死发作的年龄。
方法：在1998～2005年从一个地区综合医院诊断首次心肌梗死的出院或者死亡的患者，得到1784个连续的病例（38.3%为女性）。分析首次急性心肌梗死的年龄。
结果：未调整的首次心肌梗死的平均年龄女性为76.2岁，男性为69.8岁，差别为6.4岁(P<0.001). 不同组的平均年龄为：非吸烟女性80.7岁，吸烟女性66.2岁，差别14.4岁(P<0.001)；非吸烟男性为72.7岁，吸烟男性为63.9岁，差别8.3岁(P<0.001)。在进行了危险因素（高血压、胆固醇水平、糖尿病）和患者特征（心绞痛病史、中风病史）调整后女性首次心肌梗死13.7年的年龄差别归因于吸烟；男性有6.2年的年龄差别归因于吸烟。
结论：吸烟者中提前发生首次急性心肌梗死的时间女性显著早于男性，提前发生首次心肌梗死的年数女性吸烟者大概是男性吸烟者的2倍。
方法：在1998～2005年从一个地区综合医院诊断首次心肌梗死的出院或者死亡的患者，得到1784个连续的病例（38.3%为女性）。分析首次急性心肌梗死的年龄。
结果：未调整的首次心肌梗死的平均年龄女性为76.2岁，男性为69.8岁，差别为6.4岁(P<0.001). 不同组的平均年龄为：非吸烟女性80.7岁，吸烟女性66.2岁，差别14.4岁(P<0.001)；非吸烟男性为72.7岁，吸烟男性为63.9岁，差别8.3岁(P<0.001)。在进行了危险因素（高血压、胆固醇水平、糖尿病）和患者特征（心绞痛病史、中风病史）调整后女性首次心肌梗死13.7年的年龄差别归因于吸烟；男性有6.2年的年龄差别归因于吸烟。
结论：吸烟者中提前发生首次急性心肌梗死的时间女性显著早于男性，提前发生首次心肌梗死的年数女性吸烟者大概是男性吸烟者的2倍。
（张永明编译 刘国梁审校）
European Journal of Cardiovascular Prevention & Rehabilitation. 2009 Feb:25 ,Publish Ahead of Print.
（注：题目，下同）
Sex-based differences in premature first myocardial infarction caused by smoking: twice as many years lost by women as by men.
（注：作者，下同）
（注：作者，下同）
Grundtvig, Morten a; Hagen, Terje P. b; German, Mikael a; Reikvam, Asmund c.
(a)Department of Medicine, Innlandet Hospital Trust, Division Lillehammer, Lillehammer (b)Institute of Health Management and Health Economics (c)Department of Pharmacotherapeutics, Faculty of Medicine, University of Oslo, Oslo, Norway
（注：摘要，下同）
(a)Department of Medicine, Innlandet Hospital Trust, Division Lillehammer, Lillehammer (b)Institute of Health Management and Health Economics (c)Department of Pharmacotherapeutics, Faculty of Medicine, University of Oslo, Oslo, Norway
（注：摘要，下同）
Background: It has been debated whether smoking increases the risk of heart disease relatively more in women than in men. It is not known whether there are sex differences with regard to how many years prematurely smoking causes acute myocardial infarction (AMI) to occur. We aimed to determine how smoking affects the age of onset of first myocardial infarction in both the sexes.
Design: Clinical data were consecutively entered into a database and were analysed with a multivariate regression technique.
Methods: In the years 1998-2005, data on 1784 consecutive patients (38.3% women) who were discharged from or died in a district general hospital with a diagnosis of first myocardial infarction were included in the study. Age at first AMI was analysed.
Results: Unadjusted mean ages were 76.2 years for women and 69.8 years for men, a difference of 6.4 years (P<0.001). Mean age within the various groups was: women nonsmokers 80.7 years, women smokers 66.2 years, difference 14.4 years (P<0.001); men nonsmokers 72.2 years, men smokers 63.9 years, difference 8.3 years (P<0.001). After adjustment for risk factors (hypertension, cholesterol levels, diabetes) and patient characteristics (history of angina, history of stroke) 13.7 years of the age difference in women were attributed to smoking; the corresponding figure in men was 6.2 years (P<0.001).
Design: Clinical data were consecutively entered into a database and were analysed with a multivariate regression technique.
Methods: In the years 1998-2005, data on 1784 consecutive patients (38.3% women) who were discharged from or died in a district general hospital with a diagnosis of first myocardial infarction were included in the study. Age at first AMI was analysed.
Results: Unadjusted mean ages were 76.2 years for women and 69.8 years for men, a difference of 6.4 years (P<0.001). Mean age within the various groups was: women nonsmokers 80.7 years, women smokers 66.2 years, difference 14.4 years (P<0.001); men nonsmokers 72.2 years, men smokers 63.9 years, difference 8.3 years (P<0.001). After adjustment for risk factors (hypertension, cholesterol levels, diabetes) and patient characteristics (history of angina, history of stroke) 13.7 years of the age difference in women were attributed to smoking; the corresponding figure in men was 6.2 years (P<0.001).
Conclusion: First AMI occurred significantly more prematurely in women than in men smokers, implying that twice as many years were lost by women as by men smokers.
DOI Number 10.1097/HJR.0b013e328325d7f0
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