Risk Factors for Myocardial Infarction in Women and Men: a Case Control Study

Objectives: Cardiovascular disease has been the leading cause of death in both sexes in Serbia in the last decades. The aim of this study was to examine sex differences in risk factors for myocardial infarction in Serbia. Materials and methods: A hospital-based case-control study analyzing risk factors for myocardial infarction was conducted at the University Clinical Centre in Kragujevac (Serbia). We investigated the following risk factors: occupation, education level, marital status, family history, psychosocial distress, body mass index, blood pressure, cholesterol level, diabetes mellitus, smoking status, alcohol use, and menopause. Logistic regression analysis was used to determine odds ratio (OR) with 95% confidence intervals (95% CI). Results: Our study comprised 374 participants: 187 newly diagnosed patients with myocardial infarction and 187 controls. Cases and controls were individually matched by gender, age (±2 years), and place of residence (rural / urban). Analysis of cardiovascular risk factors by sex revealed that the increase of risk for acute myocardial infarction was associated with obesity (OR=2.17; 95%CI=1.13-4.16), stressful life events in personal history (OR=2.88; 95%CI=1.53-5.43) and cholesterol level (OR=7.57; 95%CI=2.02-28.43) in men, while diabetes mellitus (OR=5.19; 95%CI=1.60-6.80), smoking (OR=3.08; 95%CI=1.45-6.53) and menopause (OR=5.62; 95%CI=1.10-28.76) were associated with increased risk in women. Conclusion: Our study noted sex differences in risk factors for myocardial infarction. Additional analytic epidemiological studies addressing cardiovascular risk factors are needed.