Reduction in the incidence of acute myocardial infarction associated with a citywide smoking ordinance
Reduction in the incidence of acute myocardial infarction associated with a citywide smoking ordinance
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DOI：
10.1161/circulationaha.106.615245
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发表时间：
2006-10-03
期刊：
影响因子：
37.8
通讯作者：
Krantz, Mori J.
中科院分区：
文献类型：
--
作者：
Bartecchi, Carl;Alsever, Robert N.;Krantz, Mori J.
背景：二手烟暴露会增加急性心肌梗死（AMI）的风险。一项研究（蒙大拿州海伦娜）调查了这个问题，发现AMI的减少与无烟法令有关。我们试图确定无烟法令对另一个地理上孤立的社区（科罗拉多州普韦布洛）AMI入院率的影响。方法和结果：我们评估了普韦布洛3年期间、无烟法令实施前1.5年和实施后1.5年的AMI住院情况。我们比较了居住在城市范围内（该条例适用的地区）与居住在城市范围外的个人的急性心肌梗塞住院率。我们还比较了这段时间内另一个地理上孤立但邻近的社区——科罗拉多州埃尔帕索县（El Paso County）的AMI发病率，该社区没有相关法令。在2002年1月1日至2004年12月31日期间，共有855名被诊断为原发性AMI的患者在普韦布洛住院。在该法令颁布后的一段时间内，普韦布洛市区居民AMI住院率有所下降（相对危险度[RR]=0.73, 95%可信区间[CI] 0.63 ~ 0.85）。在同一时期，非市区居民（RR=0.85, 95% CI 0.63至1.16）或埃尔帕索县居民（RR=0.97, 95% CI 0.89至1.06）的AMI发生率未见显著变化。即使在季节性趋势调整后，普韦布洛地区AMI发生率的降低与外部对照组（埃尔帕索县）的变化也有显著差异（P < 0.001）。结论：在科罗拉多州普韦布洛，一项减少二手烟暴露的公共法令与AMI住院率的降低有关，这支持了先前一项较小研究的数据。
Background-Secondhand smoke exposure increases the risk of acute myocardial infarction (AMI). One study (Helena, Mont) examined the issue and found a decrease in AMI associated with a smoke-free ordinance. We sought to determine the impact of a smoke-free ordinance on AMI admission rates in another geographically isolated community (Pueblo, Colo).Methods and Results-We assessed AMI hospitalizations in Pueblo during a 3-year period, 1.5 years before and 1.5 years after implementation of a smoke-free ordinance. We compared the AMI hospitalization rates among individuals residing within city limits, the area where the ordinance applied, versus those outside city limits. We also compared AMI rates during this time period with another geographically isolated but proximal community, El Paso County, Colo, that did not have an ordinance. A total of 855 patients were hospitalized with a diagnosis of primary AMI in Pueblo between January 1, 2002, and December 31, 2004. A reduction in AMI hospitalizations was observed in the period after the ordinance among Pueblo city limit residents (relative risk [RR]=0.73, 95% confidence interval [CI] 0.63 to 0.85). No significant changes in AMI rates were observed among residents outside city limits (RR=0.85, 95% CI 0.63 to 1.16) or in El Paso County during the same period (RR=0.97, 95% CI 0.89 to 1.06). The reduction in AMI rate within Pueblo differed significantly from changes in the external control group (El Paso County) even after adjustment for seasonal trends (P < 0.001).Conclusions-A public ordinance reducing exposure to secondhand smoke was associated with a decrease in AMI hospitalizations in Pueblo, Colo, which supports previous data from a smaller study.