ASSOCIATION BETWEEN TOENAIL SELENIUM AND RISK OF ACUTE MYOCARDIAL-INFARCTION IN EUROPEAN MEN - THE EURAMIC STUDY

The association between selenium status and risk of acute myocardial i nfarction was examined in a multicenter case-control study in 10 cente rs from Europe and Israel in 1991-1992. Selenium in toenails was asses sed for 683 nonfatal male cases with first acute myocardial infarction and 729 controls less than 70 years of age. Median toenail selenium c ontent was 0.553 mu g/g for cases and 0.590 mu g/g for controls. After adjustment for age, center, and smoking, the odds ratio for myocardia l infarction in the highest quintile of selenium as compared with the lowest was 0.63 (95 percent confidence interval 0.37-1.07, p for trend = 0.08). The observed inverse trend was somewhat stronger when the au thors adjusted for vitamin E status (p = 0.05). Analysis stratified fo r smoking habits showed an inverse association in former smokers (odds ratio for the 75th-25th percentile contrast = 0.63 (95 percent confid ence interval 0.43-0.94)), but not in current smokers (odds ratio = 0. 97 (0.71-1.32)) or in those who had never smoked (odds ratio = 1.55 (0 .87-2.76)). Analysis stratified by center showed a significant inverse association between selenium levels and risk of myocardial infarction for Germany (Berlin) only (75th to 25th percentile odds ratio = 0.62 (95 percent confidence interval 0.42-0.91)), which was the center with the lowest selenium levels. it appears that the increased risk of acu te myocardial infarction at low levels of selenium intake is largely e xplained by cigarette smoking; selenium status does not appear to be a n important determinant of risk of myocardial infarction at the levels observed in a large part of Europe.