title: Smoking and myocardial infarction in women: a case-control study from northern Italy.
abstract: OBJECTIVE
  To examine the relationship between smoking and myocardial infarction in women.
  
  
  METHODS
  Case-control study over 5 years.
  
  
  METHODS
  Cases were women admitted to 30 coronary care units in northern Italy. Controls were admitted to the same hospitals with other acute disorders.
  
  
  METHODS
  These were 262 young and middle aged women with acute myocardial infarction (median age 49 years, range 24-69) and 519 controls with other acute disorders unrelated to ischaemic heart disease (median age 47 years, range 22-69).
  
  
  RESULTS
  Stratification and the Mantel-Haenszel procedure, and unconditional multiple logistic regression were used to obtain relative risks according to levels of cigarette smoking. The regression equations included terms for age, education, coffee and alcohol consumption, diabetes, hypertension, hyperlipidaemia, body mass index and oral contraceptive use. Compared to life long non-smokers, relative risk was not significantly above unity for ex-smokers but among current smokers showed a significant trend to increasing risk with larger numbers of cigarettes smoked, with risk estimates of 2.3, 5.9 and 11.0 for less than 15, 15-24 and greater than or equal to 25 cigarettes per day respectively. Smoking related risks were consistently raised across strata of hyperlipidaemia, hypertension and increased alcohol and coffee intake.
  
  
  CONCLUSIONS
  In terms of population attributable risk, about 48% of all myocardial infarctions in young and middle aged Italian women were attributable to cigarette smoking, which is therefore by far the most important preventable determinant of the disease.
authors.affiliation: Mario Negri Institute for Pharmacological Research, Milan, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Gramenzi
authors.forename: A
authors.initials: A
authors.lastname: Gentile
authors.forename: M
authors.initials: M
authors.lastname: Fasoli
authors.forename: B
authors.initials: B
authors.lastname: D'Avanzo
authors.forename: E
authors.initials: E
authors.lastname: Negri
authors.forename: F
authors.initials: F
authors.lastname: Parazzini
authors.forename: C
authors.initials: C
authors.lastname: La Vecchia
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007558:Italy; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology*; D012044:Regression Analysis; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*