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Smoking a bigger player in STEMI for younger patients


 Ann Arbor, MI - Smoking seems to play a bigger role in acute ST-segment-elevation MI (STEMI) in patients younger than 35 years compared with older age groups. A study based on Michigan data suggests that cigarette smoking remains common overall in patients who undergo PCI for STEMI, but the likelihood is 11-fold higher in that youngest adult age group [1]. Prevalence of smoking among STEMI patients also tapered down with increasing age, report the authors, led by Dr Gail K Larsen (University of Michigan, Ann Arbor).

"Notably, our study estimates that a reduction in the smoking rate down to 12%, an objective laid out by People 2020, would translate to more than 450 STEMIs prevented per year in Michigan alone," they write in their report, published online May 27, 2013 in JAMA Internal Medicine.

In their analysis of 2010-2012 data from 44 hospital participants in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2) registry, which enters "all patients undergoing PCI at nonfederal hospitals" in the state, the prevalence of smokers among all 6892 patients undergoing PCI for STEMI was 46.4%—which contrasts with 20.5% of the general population, according to the group.

Compared with the general population, the odds ratio for smoking among the STEMI patients was 11.4 (95% CI 10.0-12.8) for the 18-34 age group; it was significantly increased for all other age groups as well but declined steadily with every four-year increment in age, from 8.9 (95% CI 7.7-10.0) for age 35-39 down to only 2.7 (95% CI 2.4-3.0) for >65 years.

"Aggressive efforts should be made to promote smoking cessation for primary prevention of major cardiovascular events, with a specific focus in younger age groups."

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