Sex-specific association between secondhand smoke exposure and acute coronary syndrome using KoGES epidemiological cohort data

Abstract

While numerous studies highlight sex differences in the adverse effects of direct smoking, research on sex-specific risks from secondhand smoking (SHS)-induced diseases is sparse. We hypothesized that acute coronary syndrome (ACS) could be influenced by SHS exposure, with effects varying by sex. We utilized the Korea Genome Epidemiology Study (KoGES) data which was collected starting from 2001 and follow-up for 19 years, to conduct our study. Our primary exposure was secondhand smoke (SHS), and the main outcome of interest was acute coronary syndrome (ACS). We conducted Cox proportional logistic regression analysis and performed an interaction analysis to investigate the interaction between SHS and sex in relation to ACS incidence. SHS exposure was not associated with an increased risk of ACS, exhibiting a hazard ratio (HR) of 1.44 (95% confidence interval (CI), 0.88–1.49) in comparison to the non-exposed group. In the interaction analysis between SHS exposure and sex on the incidence of ACS, in females, SHS was not a risk factor for ACS (HR: 0.97 (95% CI: 0.70–1.35)), whereas, in males, SHS was a significant risk factor for ACS (HR: 1.63 (1.02–2.60). We identified a significant association between SHS exposure and an increased risk of ACS in males. Our findings emphasize the importance of minimizing secondhand smoke exposure, particularly among the male demographic.

Keywords

• secondhand smoke
• sex
• acute coronary syndrome