title: The association between secondhand smoke and the risk of developing acute coronary syndromes, among non-smokers, under the presence of several cardiovascular risk factors: The CARDIO2000 case-control study.
abstract: BACKGROUND
  The purpose of this study was to investigate the association between secondhand smoke and the risk of developing a first event of acute coronary syndromes (ACS), i.e. acute myocardial infarction or unstable angina, among non-smokers, in relation to the presence of several other cardiovascular risk factors.
  
  
  METHODS
  Eight hundred and forty-eight patients with first event of ACS and 1078 cardiovascular disease-free matched controls completed a detailed questionnaire regarding their exposure to secondhand smoke, among other investigated parameters.
  
  
  RESULTS
  Two hundred and ninety-seven (35%) of the patients and 259 (24%) of the controls were defined as secondhand smokers. After controlling for several potential confounders, the results showed that non-smokers occasionally (< 3 time per week) exposed to cigarette smoke were associated with 26% higher risk of ACS (OR = 1.26, P-value < 0.01) compared to non-smokers not exposed to smoke, while regular exposure is associated with 99% higher risk of developing ACS (OR = 1.99, P-value < 0.001). Moreover, the previous risk increases progressively from 15% to 256% if one or more of the classical cardiovascular risk factors (i.e. hypertension, hypercholesterolemia, diabetes mellitus, sedentary life and family history of premature coronary heart disease) are present.
  
  
  CONCLUSIONS
  Consequently, this study supports the hypothesis that even occasional secondhand smoke increases the risk of developing acute coronary syndromes, especially when other risk factors are present. Given the high prevalence of cigarette smoking, the public health consequences of passive smoking with regard to coronary heart disease are important.
authors.affiliation: Section of Preventive Cardiology, Department of Cardiology, School of Medicine, University of Athens, Athens, Greece. dbpanag@math.uoa.gr
authors.forename: Demosthenes B
authors.initials: DB
authors.lastname: Panagiotakos
authors.forename: Christina
authors.initials: C
authors.lastname: Chrysohoou
authors.forename: Christos
authors.initials: C
authors.lastname: Pitsavos
authors.forename: Ioanna
authors.initials: I
authors.lastname: Papaioannou
authors.forename: John
authors.initials: J
authors.lastname: Skoumas
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Stefanadis
authors.forename: Pavlos
authors.initials: P
authors.lastname: Toutouzas
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000789:Angina, Unstable / Q000453:epidemiology* / Q000209:etiology; D016022:Case-Control Studies; D015984:Causality; D004781:Environmental Exposure / Q000009:adverse effects* / Q000706:statistics & numerical data; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000209:etiology; D016017:Odds Ratio; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000009:adverse effects* / Q000706:statistics & numerical data
chemical_list: D014028:Tobacco Smoke Pollution