Abstract 13275: Eastern-European and African Immigrants Have Higher Risk of Out-of-Hospital Cardiac Arrest Compared to Other Danish Immigrants

Abstract

Introduction: American studies have pointed out racial disparities regarding Out-of-Hospital Cardiac Arrest (OHCA) occurrence, but to date, no data exists among immigrants in Europe. Hypothesis: The risk of OHCA may vary according to region of origin among immigrants. Methods: This nationwide study included all immigrants identified from the Danish Cardiac Arrest Register with OHCA with presumed cardiac cause between 18 and 80 years from 2001 to 2014. Regions of origin were defined as Asia, Western countries, Eastern Europe, Africa, South America, and Arabic countries. Results: Overall, among 940,207 immigrants present in Denmark, a total of 1,724 (0.2%) OHCA (median 62 (IQR 50,71) years 70% males) were recorded. History of myocardial infarction, heart failure, and diabetes were present in 23%, 18%, and 16% respectively. 217 OHCA occurred in Asians, 673 in Westerners, 347 in Eastern Europeans, 107 in Africans, 19 in South Americans, and 361 in Arabic immigrants.Crude incidence rate (/ 100 000 person-years) was 15.2 (95%CI 9.14-23.7) in South American, 19.4 (95%CI 16.9-22.2) in Asian, 22.8 (95%CI 18.7-27.5) in African, 24.7 (95%CI 22.2-27.3) in Arabic, 26.2 (95%CI 23.5-29.1) in Eastern European and 32.4 (95%CI 30.0-34.9) in Western immigrants.After Cox regression, factors associated with OHCA were Eastern European origin (HR 1.28, 95%CI 1.13-1.47; P<0.001), African origin (HR 1.31, 95%CI 1.07-1.61; P=0.01), male sex (HR 1.89, 95%CI 1.70-2.10; P<0.001), age (HR 1.05, 95%CI 1.04-1.06; P<0.001), ischemic heart disease (HR 52.02; 95%CI 39.41-68.67; P<0.001), diabetes (HR 7.04; 95%CI 5.42-9.16; P<0.001), and heart failure (HR 1.33, 95%CI 1.06-1.64; P=0.01). Conclusions: This is the first European study assessing the incidence of OHCA among immigrants according to their region of origin. Eastern European and African immigrants had a higher risk of OHCA compared to South American, Asian, Arabic and Western immigrants.