Findings have been published from the ‘The Maltese Acute Myocardial Infarction Study’ on the effects of smoking, alcohol consumption and diabetes mellitus on the risk of myocardial infarction in the Maltese.

Active smoking is a well-known risk factor of myocardial infarction. Research carried out on the Maltese population, revealed that smokers have three times the risk of myocardial infarction compared with non-smokers.

On the other hand, moderate alcohol consumption protected against myocardial infarction. However, this beneficial effect depends on the frequency of drinking. Daily binge drinkers have a five times higher risk of myocardial infarction compared with individuals who drink moderate amounts of alcoholic beverages.

Smoking cessation decreases this risk of myocardial infarction, with ex-smokers having a lower risk of myocardial infarction compared with current smokers. This risk goes on decreasing as more years pass since stopping smoking.

Apart from active smokers, Maltese exposed to passive smoking either in public or at home also have an increased risk of myocardial infarction. The risk is stronger in a home setting, where even periods of less than 1 hour of passive smoke exposure increase risk.

Similar to active smoking, diabetes mellitus is another strong risk factor of myocardial infarction amongst the Maltese.

A total of 14.2% of the Maltese population are diabetic, out of which 7.9% fail to control their blood glucose levels. These uncontrolled diabetics have three times the risk of myocardial infarction compared with non-diabetics.

On the other hand, diabetics with good glycaemic controls show no risk of myocardial infarction. These findings strongly indicate that controlling blood glucose levels eliminates the risk of myocardial infarction associated with diabetes.

The Study found that despite population-wide free access to testing, an alarming 2.5% of the Maltese population have undiagnosed diabetes. The risk of myocardial infarction amongst these individuals is almost four times higher than that of non-diabetics.

These findings highlight the importance of early diagnosis and the benefits of better diabetes control, as such measures can overcome the impact of diabetes on the risk of myocardial infarction.

This research, presented by Ms Ritienne Attard at the 82nd Congress of the European Atherosclerosis Society, was carried out on the ‘The Maltese Acute Myocardial Infarction Study’ (MAMI Study), a collection of samples from around 1,000 Maltese individuals.

The MAMI Study is a collaboration between the University of Malta and the Department of Health, under the co-ordination of Dr Stephanie Bezzina Wettinger and supported by national funding through the R & I programme (2008) administered by the Malta Council for Science and Technology (MCST), and various MGSS and STEPS students scholarships.

Both smoking and diabetes mellitus affect the inflammatory state. Based on these findings further investigation on the impact of inflammation on the risk of myocardial infarction are being conducted.

Inheritance of inflammatory profiles within Maltese families is currently being investigated as part of the Next Generation Sequencing Project, funded through National R & I programme (2012).

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