Resumo

LEAL-MATEOS, Manrique  e  SOLANO- CHINCHILLA, Teresita. Tabaquismo como factor de riesgo del infarto agudo al miocardio. Acta méd. costarric [online]. 2006, vol.48, n.2, pp.72-76. ISSN 0001-6002.

Rationale: Cigarrette smoking is the main, preventable cause of premature illness, disability and death worldwide. At present, is widely recognized as a risk factor for the development of cardiovascular disease. Nevertheless, even though tobacco is generaly accepted as a direct cause of acute myocardial infarction, in our country, knowledge about its attributable fraction is limited. Objective: The purpose of this study is to evaluate the impact of cigarrette smoking on acute myocardial infarction patients measuring its attributable fraction. With this study, our purpose is to estimate the proportion of patients who could prevent the development of an acute myocardial infarction if exposure to this risk factor was avoided. Methods: A case-control study was done in the internal medicine and surgery wards at the San Juan de Dios Hospital comprising the period between april the 1st and september the 23rd of 2005. A smoker was defined as any patient which had smoked, at least, 1 cigarrette a day during 1 year. According to their smoking habits, the patients were classified as: non smokers (never smoked), smokers (current smokers) and ex-smokers. The magnitude of the associations between the exposure and the risk of illness was measured by means of the 2:1 paired odds ratio in which we defined those not exposed as the non smokers. Those who had not smoked for over 15 years were classified as non smokers (given the long-term benefits which quitting entails) and those who had not smoked for less than 15 years were classifed as smokers. To measure the impact of cigarrette smoking on acute myocardial infarction patients, we used the indicator called Attributable Fraction. For this purpose, we used the EPITABLE feature a in EpiInfo 6®. Results: The 2:1, paired odds ratio showed a positive association between smoking and the development of acute myocardial of 2.58 (95% CI 1.17 to 5.70) The attributable fraction in those exposed was 64.7% (95% CI 14.6 to 82.5). Conclusion: Slightly over half of the cases diagnosed as acute myocardial infarction at the San Juan de Dios Hospital are related to cigarrette smoking.

Palavras-chave : Tobacco; acute myocardial infart; epidemiology; attributable fraction.