El tabaquismo y su fracción atribuible en la enfermedad isquémica cardiaca

Objective. To assess the impact of cigarette smoking oncoronary heart disease (CHD) and to propose a simple andefficient method to estimate its attributable fraction (AF).Material and Methods. A matched case-control study wasconducted in the Regional Hospital of Instituto Mexicanodel Seguro Social (...

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Detalhes bibliográficos
Autores: Eduardo Lazcano, Luisa María Sánchez, Luis Alfredo López, Adrián Estrada, Eduardo Salazar, Mauricio Hernández
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2002
País:México
Recursos:Instituto Mexicano del Seguro Social
Repositorio:Redalyc-IMSS
OAI Identifier:oai:redalyc.org:10644508
Acesso em linha:https://www.redalyc.org/articulo.oa?id=10644508
Access Level:acceso abierto
Palavra-chave:Salud
Mexico
smoking
attributable fraction
Key words: myocardial infarction
Descrição
Resumo:Objective. To assess the impact of cigarette smoking oncoronary heart disease (CHD) and to propose a simple andefficient method to estimate its attributable fraction (AF).Material and Methods. A matched case-control study wasconducted in the Regional Hospital of Instituto Mexicanodel Seguro Social (Mexican Institute of Social Security) inMorelos State, Mexico, from May to June-2000. Cases were80 prevalent and incident patients with CHD. One-hundredsixtycontrols matched by sex and age were randomlyselected from the outpatient clinic. The attributable fractionwas obtained through summary estimators, variances, andconfidence intervals for matched designs with more thanone control per case. Results. The prevalence of cigarettesmoking previous to the coronary event was 80%, comparedto 62.1% in controls. Mantel-Haenszel odds ratios showeda positive association of cigarette smoking with CHD (OR,6.7; 95% CI, 3.2-13.8). The attributable fraction among theexposed was 85% (95% CI, 74-95) while the populationattributable fraction was 56% (95% CI, 45-66). The AF inexposed was 65% for males (95% CI, 53-77) and 31% forfemales (95% CI 14-47). Conclusions. The long-termsmoking AF on CHD is greater than 85%. Such a high AFshould be countered with the implementation of primaryprevention measures to encourage smoking cessation andwith smoking cessation clinics for active smokers. These arethe two most important public health interventions toclínicas antitabaco en fumadores activos, continúan siendolas más relevantes medidas de salud pública actuales, nosólo para prevenir enfermedad cardiovascular, sino un granespectro de enfermedades crónicas. El texto completoen inglés de este artículo está disponible eh: http://www.insp.mx/salud/index.html