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 For women smokers ages 18 to 49, the risk of a deadly type of heart
attack was more than 13 times higher than it was for non-smoking
counterparts, researchers reported in the Journal of the American
College of Cardiology.
"This study sheds new light on the risk impact that smoking has in
provoking major heart attacks, especially in younger and female
smokers," said coauthor Dr. Ever Grech, an interventional
cardiologist at the South Yorkshire Cardiothoracic Center at the
Northern General Hospital in Sheffield, UK. "I hope (the study) will
correct the perception by young smokers that heart attack risks only
arise much later in life."
There was the hint of some good news in the new study. When women
quit smoking, their risk of a major heart attack dropped back to
that of non-smokers.
"This reversibility was a surprise, which I regard as a 'silver
lining' within the dark cloud of smoking outcomes," Grech said in an
email. "This will undoubtedly incentivize those smokers who may have
genuine concerns regarding their longer term health and realize the
massive benefits of abstaining."
Grech and his colleagues studied five years of data on patients who
came to their hospital with a so-called ST elevation myocardial
infarction (STEMI), which results from a complete blockage of a
major coronary artery.
Grech and his colleagues compared the 3,343 STEMI patients with data
on the entire population served by the South Yorkshire
Cardiothoracic Centre using 3 years of information gathered on
residents aged 18 or older by the Integrated Household Survey from
the United Kingdom Office for National Statistics.
After analyzing all the data, the researchers determined that
smoking was associated with a significantly greater increase in the
STEMI risk for women than men. Compared to their nonsmoking
counterparts, female smokers were 6.62 times more likely to have a
major heart attack, while male smokers were 4.40 times more likely
to have a major heart attack.
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Younger women smokers, those under age 50, saw the highest increase
in risk. They were 13.22 times more likely to experience a major
heart attack compared to their nonsmoking counterparts. Male smokers
in the same age group were 8.6 times more likely to experience a
STEMI compared to nonsmoking counterparts.
The researchers also found the risk of a STEMI in women who had quit
smoking for at least a month dropped back to that of nonsmokers. The
caveat to that finding is that 38% of ex-smokers did not have
information in their records detailing the date they quit.
Grech suspects the reason for the increased risk of STEMI in younger
women is tied to the impact of smoking on the hormone estrogen.
"What is clear is that the protective effects of estrogen in young
female smokers are overridden by the powerful impact of cigarette
smoking," he said.
The researchers focused on STEMIs because this is the type of heart
attack most likely to kill you, said Dr. Omar Ali, director of the
cardiac catheterization lab at the Detroit Medical Center's Heart
Hospital.
"This is a very interesting study," Ali said. "They found that not
only was smoking associated with an increased risk of this type of
heart attack, but also that the increase in risk was much higher in
women. This was not a surprise to me. But it sheds new light on the
relationship between women and heart disease."
"A lot of people are showing interest in specializing in heart
disease in women and this study certainly supports that," Ali said.
"We need to learn more about how heart disease affects women and how
the risk factors increase or decrease."
SOURCE: http://bit.ly/2WZ690L Journal of the American College of
Cardiology, online June 24, 2019.
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