Risk factors for non-fatal acute myocardial infarction in Italian women

Background. We analyzed the relation between selected lifestyles and diseases and the risk of non-fatal acute myocardial infarction (AMI) in women in Northern Italy. Methods. We used a combined data set from three case-control studies, including 558 cases and 1,044 hospital controls. Results. The strongest risk factor for AMI was smoking, the odds ratio (OR) being 4.0 in current smokers (11.6 for greater than or equal to 25 cigarettes/day). Other risk factors were diabetes (OR 4.4), hypertension (OR 3.3), hyperlipidemia (OR 1.6), and family history of AMI (OR 2.1). Moderate alcohol drinking was protective (OR 0.8 for < 2 drinks/day) compared to non-drinkers, and heavy coffee drinking non-significantly increased the risk (OR 1.4 for > 3 cups/day). Inverse association was found with fish (OR 0.7 for >1 portion/week), vegetables (0.7 for greater than or equal to 10 portions/week), and fruit (OR 0.6 for 14 portions/week), while meat, whole-grain, and diary products were unrelated. Smoking effect was stronger in combination with diabetes (OR 27.7), hypertension (OR 15.7), hyperlipidemia (OR 6.3), family history of AMI (OR 8.7), and heavy coffee drinking (OR 5.7). Conclusions. The strongest risk factor for AMI was smoking, responsible of about 37% of cases, followed by diabetes, hypertension, hyperlipidemia, family history of AMI. Avoidance of smoking and increasing fish, vegetables, and fruit would reduce AMI risk of about 50%. (C) 2004 The Institute For Cancer Prevention and Elsevier Inc. All rights reserved.