Faculty Collaboration Database

Serum Cotinine and Silent Myocardial Infarction in Individuals Free from Cardiovascular Disease. Am J Cardiol 2019 Sep 01;124(5):666-670

Date

07/06/2019

Pubmed ID

31272704

DOI

10.1016/j.amjcard.2019.05.064

Scopus ID

2-s2.0-85068043845 (requires institutional sign-in at Scopus site)   6 Citations

Abstract

Serum cotinine is a sensitive and specific marker of tobacco exposure, including second-hand smoke exposure. We sought to explore the association of tobacco exposure determined by serum cotinine with electrocardiographic silent myocardial infarction (SMI). A total of 7,006 participants (59.0 ± 13.3 years; 52.6% women, 49.7% non-Hispanic whites) without cardiovascular disease from the Third National Health and Nutrition Examination Survey (NHANES III) were included in this analysis. SMI was defined as electrocardiographic evidence of MI in the absence of a history of MI. Multivariable logistic regression analysis was used to examine the association between SMI and serum cotinine tertiles. SMI was detected in 114 (1.63%) of the participants. The prevalence of SMI was higher among those with higher levels of serum cotinine (SMI prevalence was 1.25%, 1.49%, and 2.14% across serum cotinine lower [0.03 to 0.12 ng/ml], middle [0.12 to 1.39 ng/ml], and higher [1.40 to 1890 ng/ml] tertiles, respectively). In a model adjusted for potential confounders, participants within the highest serum cotinine tertile had significantly greater odds of SMI (odds ratio [95% confidence interval]: 2.51 [1.55 to 4.08]) compared with those with serum cotinine levels in the first tertile. Each 10 ng/ml increase in serum cotinine levels was associated with a 2% (p <0.0001) increase in the prevalence of SMI. This association was stronger in white than nonwhite participants (interaction p value = 0.05). In conclusion, elevated serum cotinine levels are associated with SMI. These findings further highlight the risk associated with passive and active smoking on cardiovascular health and underscore the potential utility of serum cotinine in identifying those at risk.

Author List

Brunetti R, Hicklin H, Rackley J, Ahmad MI, Li Y, Soliman EZ

Author

Muhammad Imtiaz Ahmad MBBS Assistant Professor in the Medicine department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Asymptomatic Diseases
Biomarkers
Cardiovascular Diseases
Cohort Studies
Cotinine
Electrocardiography
Female
Humans
Male
Middle Aged
Myocardial Infarction
Nutrition Surveys
Predictive Value of Tests
Prevalence
Prognosis
Risk Assessment
Smoking
Tobacco Smoke Pollution