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. 2011 Mar 24;11:13. doi: 10.1186/1471-2261-11-13

Table 3.

Multivariable Adjusted Rate Ratios for Smoking in the CAREMA Cohort, 1987-2003

Acute Myocardial Infarction Unstable Angina Pectoris
Cases/person-years Adjust. 1a Adjust. 2b Cases/person-years Adjust. 1a Adjust. 2b
RR 95% CI RR 95% CI RR 95% CI RR 95% CI P heterogeneityc
Smoking status
Never 57/70,666 1 reference 1 reference 55/70,666 1 reference 1 reference
Ex 93/54,638 1.30 0.93, 1.81 1.31 0.93, 1.83 86/54,638 1.33 0.94, 1.88 1.36 0.96, 1.93
Current 270/84,269 3.38 2.53, 4.51 3.08 2.29, 4.14 133/84,269 1.77 1.28, 2.43 1.64 1.18, 2.27 <0.001
P trend <0.001 <0.001 <0.001 0.003
Frequency (cig/day)d,e
Never 57/70,666 1 reference 1 reference 55/70,666 1 reference 1 reference
>0 - 5 15/10,793 1.80 0.86, 3.79 1.88 0.89, 3.97 8/10,793 1.74 0.66, 4.55 1.89 0.71, 4.99
>5 - 10 42/17,687 2.73 1.41, 5.31 2.59 1.33, 5.04 24/17,687 2.98 1.27, 7.01 2.95 1.24, 7.01
>10 - 15 49/19,261 2.74 1.40, 5.35 2.54 1.30, 4.99 36/19,261 3.99 1.71, 9.34 3.91 1.65, 9.24
>15 - 20 78/19,954 3.94 2.04, 7.61 3.20 1.65, 6.20 34/19,954 3.46 1.45, 8.27 2.94 1.22, 7.11
>20 86/16,574 4.97 2.56, 9.64 3.98 2.05, 7.75 31/16,574 3.52 1.46, 8.49 3.06 1.25, 7.48 0.01
P trend <0.001 <0.001 0.01 0.09
Continuous, 5-cigarettes/day incrementsf 270/84,269 1.14 1.06, 1.21 1.08 1.01, 1.15 133/84,269 1.05 0.96, 1.16 1.00 0.90, 1.10 0.09
Duration (yrs)e,g
Never 57/70,666 1 reference 1 reference 55/70,666 1 reference 1 reference
>0 - 10 7/11,311 1.49 0.65, 3.45 1.73 0.74, 4.02 5/11,311 2.16 0.82, 5.67 2.56 0.97, 6.80
>10 - 20 34/25,705 1.96 1.19, 3.23 2.10 1.27, 3.46 10/25,705 1.07 0.50, 2.29 1.14 0.54, 2.45
>20 - 30 89/27,307 2.55 1.69, 3.85 2.73 1.80, 4.14 47/27,307 1.90 1.14, 3.18 2.03 1.21, 3.42
>30 - 40 112/16,644 2.40 1.57, 3.65 2.51 1.63, 3.85 57/16,644 1.48 0.88, 2.48 1.52 0.89, 2.57
>40 28/3,302 1.57 0.90, 2.71 1.93 1.10, 3.36 14/3,302 0.93 0.46, 1.89 1.05 0.51, 2.15 0.03
P trend <0.001 <0.001 0.29 0.21
Continuous, 10-years incrementsf 270/84,269 1.13 0.90, 1.42 1.13 0.90, 1.42 133/84,269 0.96 0.72, 1.28 0.94 0.71, 1.26 0.80
Time since quitting (yrs)h
Never 57/70,666 1 reference 1 reference 55/70,666 1 reference 1 reference
>5 61/36,603 0.87 0.55, 1.39 1.01 0.63, 1.62 53/36,603 0.92 0.54, 1.56 1.06 0.62, 1.80
>2 - 5 15/7,476 1.44 0.70, 2.96 1.43 0.69, 2.95 14/7,476 1.76 0.78, 3.98 1.73 0.76, 3.95
>0 - 2 15/9,392 1.34 0.64, 2.84 1.51 0.72, 3.18 17/9,392 1.97 0.87, 4.47 2.29 1.02, 5.16
Current 265/82,188 2.75 1.58, 4.78 2.82 1.61, 4.91 130/82,188 1.66 0.84, 3.27 1.72 0.87, 3.41 0.003
P trend <0.001 <0.001 0.03 0.06

Adjust, adjustment; CI, confidence interval; cig, cigarettes; RR, rate ratio; yrs, years.

Table summary: Smoking increased the risk of both AMI and UAP. Dose-response relationships were seen with the number of cigarettes smoked per day and the number of smoking years although this trend was less obvious for the latter. All RRs were significantly higher for AMI than for UAP (p heterogeneity < 0.03). Furthermore, the risks of AMI and UAP decreased the longer ago subjects quitted smoking.

a Rate ratios adjusted for age at baseline (years), sex, baseline cohort (PPHVZ or MORGEN), total alcohol consumption (glasses/day), diabetes mellitus (yes/no), level of education (primary school/junior vocational education, secondary vocational education or vocational college/university), and family history of premature MI (yes/no).

b Additionally adjusted for intermediates: total and HDL cholesterol levels (mmol/L), systolic blood pressure (mmHg), and body mass index (kg/m2).

c Heterogeneity test for the difference in the RRs between AMI and UAP. The p values were similar for the models with and without adjustments for intermediates.

d Additionally adjusted for duration (years).

e Exclusion of ex-smokers from the analyses.

f Analyses restricted to current smokers.

g Additionally adjusted for frequency (cigarettes/day).

h Additionally adjusted for duration (years) and number of cigarettes/day smoked in the past.