Abstract 19514: Sex Differences in Persistent Smoking Among Young Patients Following Acute Myocardial Infarction: Insights From the VIRGO Study (Variation in Recovery: Role of Gender on Outcomes of Young Acute Myocardial Infarction Patients)
Introduction: The effectiveness of secondary prevention efforts to quit smoking after acute myocardial infarction (AMI) in young women (≤55 years) is unknown. This represents an important subgroup to study, given that young women have higher post-AMI mortality versus age-matched men, and report high rates of smoking at time of their AMI. We examined sex differences in the effect of persistent smoking at 1-year post AMI, including factors associated with this outcome.
Methods: Young AMI patients (18-55 yrs) were enrolled from 103 US, 24 Spanish, and 3 Australian hospitals (2008-2012) into the VIRGO study. Smoking status was collected by baseline and 1-year interviews. Patients were categorized as never smokers, past smokers or current smokers at baseline; and current smokers were classified as quitters (N=667) or persistent smokers (N=787), based on their self-reported smoking status at 1 year. We compared sexes using t-tests/chi-squared test and logistic regression analysis, sequentially adjusting for important covariates (Figure).
Results: Over half (n=787, 54%) of participants who smoked at the time of their AMI (n=1454) continued to smoke 1 year later. This was higher for women than men (56% vs. 50%; P=0.04). Female persistent smokers were more likely to be black (17% vs. 8%, P<0.001), non-working (52% vs. 40%, P<0.003), and had higher rates of diabetes (27% vs. 19%, P=0.01), obesity (51% vs. 43%, P=0.03), and depression (58% vs. 30%, P<0.001) compared with male persistent smokers. Female sex was not significantly associated with persistent smoking after adjustment for covariates (OR=1.04, 95%CI 0.80, 1.34).
Conclusion: Young women have a higher crude rate of persistent smoking 1 year after AMI as compared with similarly aged men that is explained after adjusting for demographic and economic factors. Given that less than half of young AMI patients stop smoking within a year underscores the need for more aggressive smoking cessation efforts after AMI.
Author Disclosures: R.P. Dreyer: None. Y. Tang: None. Y. Lu: None. P.G. Jones: None. D.M. Buchanan: None. C.M. Mazure: None. S. McKee: None. M. Geda: None. G. D’Onofrio: None. J.H. Lichtman: None. H. Bueno: None. J.A. Spertus: Other; Modest; Patent Seattle Angina Questionnaire with royalities paid. H.M. Krumholz: Research Grant; Modest; U01 HL105270-05 (Center for Cardiovascular Outcomes Research at Yale University) from NHLBI. Other Research Support; Modest; Recipient of research agreements from Medtronic, Inc, and Johnson & Johnson (Janssen) through Yale University to develop methods of clinical trial data sharing. Consultant/Advisory Board; Modest; Chair of a cardiac scientific advisory board for UnitedHealth.
- © 2016 by American Heart Association, Inc.