Temporal trends over 20 years of smoking prevalence in patients with acute myocardial infarction. Data from the RICO survey

Type of funding sources: Public Institution(s). Main funding source(s): ARS Bourgogne Franche Comté

Over the last 2 decades, tobacco smoking, a major cardiovascular (CV) risk factor, has decreased in France, but remains among the highest in European countries.

From a large database of patients with acute myocardial infarction (MI), we aimed to investigate the evolution of smoker’s prevalence and characteristics over a 20-y period.

From the RICO survey, 18,769 patients hospitalized from 2001 to 2020 for an acute MI in one region of France were included. Current smokers were compared with ex-smokers or non-smokers and according to gender.

Temporal trends showed that smoking rate did not decrease in men and dramatically increased in women by 50% (figure). Rate of smoking was higher in men than in women (34% vs 18%, p<0.001). Median age increased across the year groups whatever the smoking status. When compared with ex or non-smokers, smokers were much younger (54 vs 71 y for men and 56 vs 79 y for women, p<0.001), had more frequent family history of CAD but less modifiable risk factors such as diabetes and hypertension. ST-segment elevation MI was more common in smokers, for both sex. Although in-hospital adjusted mortality was similar for both groups, smokers had more common ventricular arrhythmias (VF/VT).

Over the last 2 decades, tobacco use remains common in patients with acute MI and is associated with a younger age of occurrence and severe acute complications. Our findings also reveal an alarming increasing prevalence of smoking in women. More effective prevention strategies are necessary to reduce tobacco use, in particular in women.