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

Abstract

To analyse survival after a first myocardial infarction among immigrants in Stockholm, Sweden. 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. 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). 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.