Abstract P143: Young Women are Most Susceptible to the Effects of Smoking on Adverse Cardiovascular Events
Background. Although overall rates of smoking have declined in the U.S. population, such decline has been less in women than in men, and sex differences in smoking-related morbidity and mortality from coronary artery disease (CAD) may also exist. The purpose of this study was to determine sex and age-specific differences in the relationship between smoking and adverse cardiovascular events in patients referred for CAD evaluation.
Methods. We examined 261 current smokers and 1,561 non-smokers who underwent coronary angiography for suspected CAD. Patients were followed for repeat hospitalization or death related to major adverse cardiovascular events (MACE). CAD severity was scored based on the Coronary Artery Surgery Study scoring system.
Results. Smokers were more likely to be men (64%) and <60 years of age (62%). After a median follow-up of 2.4 years, 148 (24%) women and 345 (29%) men experienced MACE. The adjusted hazard ratio for MACE was >10-fold in women smokers <60 yrs than non smoking counterparts (Table 1), and remained significant after adjusting for CAD severity. No significant association was found in men <60 yrs or in older women or older men (sex, age and smoking interaction: p=0.03).
Conclusions. Younger women referred for coronary evaluation appear to be more susceptible to the adverse cardiovascular effects of smoking than men or older women. Our results suggest potential sex differences in CAD pathophysiology and prognosis and emphasize the need to address smoking behavior in all patients, particularly young women.
- © 2012 by American Heart Association, Inc.