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Country of birth and survival after a first myocardial infarction in Stockholm, Sweden

  • Cardiovascular Disease
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Abstract

Aim To analyse survival after a first myocardial infarction among immigrants in Stockholm, Sweden. Methods All cases of first myocardial infarction among persons 30–74 years of age during 1985–1996 in Stockholm, Sweden were identified using registers of hospital discharges and deaths. Cases surviving 28 days were followed with regard to mortality during one year. Information on country of birth was obtained from national censuses and from a register on immigration. Early mortality was analysed by odds ratios (OR) through logistic regression and 1 year mortality by hazard ratios (HR) through cox proportional hazards regression. Results Male immigrants had a lower mortality within 28 days after a first myocardial infarction compared to Sweden-born after adjustment for socioeconomic status (OR 0.84; 95% CI 0.76–0.94). Among women there was a weak similar tendency (OR 0.92; 95% CI 0.76–1.10). There were essentially no differences overall between foreign-born and Sweden-born in 1-year-mortality after adjustment for socioeconomic status (men HR 1.13; 95% CI 0.91–1.41; women HR 0.90; 95% CI 0.61–1.34). Conclusion Immigrants in Sweden in general do not seem to have a higher mortality after a first myocardial infarction than Sweden-born, in particular when differences in socioeconomic status are accounted for. A higher CHD mortality in immigrants appears to be primarily due to an elevated disease incidence.

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Acknowledgements

Funding Bank of Sweden Tercentenary Foundation (no 2000-0431 to N.H.), Academy of Finland (no 37487), Swedish Medical Research Council (no K2000-27X-13434-01 to N.H.), Swedish Council for Working Life and Social Research (no 97-0329:1B to N.H.) and Swedish Heart and Lung Foundation, EU FP5 (grant QLG2-CT-2002-01254 to N.H.). Evaluated and approved by the Ethical Committee of Karolinska Institutet, diary number 99-106.

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Authors and Affiliations

  1. Department of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

    Ebba Hedlund & Niklas Hammar

  2. Centre for Research in International Migration and Ethnic Relations, Stockholm University, 10691, Stockholm, Sweden

    Ebba Hedlund & Anders Lange

  3. AstraZeneca Research & Development, Molndal, Sweden

    Niklas Hammar

  4. Department of Cardiology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

    Kenneth Pehrsson

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  1. Ebba Hedlund
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  4. Niklas Hammar
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Correspondence to Ebba Hedlund.

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Hedlund, E., Pehrsson, K., Lange, A. et al. Country of birth and survival after a first myocardial infarction in Stockholm, Sweden. Eur J Epidemiol 23, 341–347 (2008). https://doi.org/10.1007/s10654-008-9240-8

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