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Myocardial infarction in second-generation immigrants compared to native-born Swedes in the total population of Sweden

Wändell, Per LU ; Li, Xinjun LU ; Carlsson, Axel C. ; Sundquist, Jan LU and Sundquist, Kristina LU (2025) In Atherosclerosis 402.
Abstract

Background and aims: Environmental and genetic factors predispose to cardiovascular disease. Some first-generation immigrants have a higher cardiovascular risk in Sweden, while less is known about second-generation immigrants. We aimed to analyze the risk of acute myocardial infarction (AMI) among second-generation immigrants in Sweden. Methods: We included all individuals 18 years of age and older in Sweden, n = 4,580,967. AMI was defined as at least one registered diagnosis in the National Patient Register between January 1, 1998, and December 31, 2018. Cox regression analysis was used to estimate the relative risk (hazard ratio = HR) with 99 % confidence interval (CI) of incident AMI with adjustments made for age, sociodemographics,... (More)

Background and aims: Environmental and genetic factors predispose to cardiovascular disease. Some first-generation immigrants have a higher cardiovascular risk in Sweden, while less is known about second-generation immigrants. We aimed to analyze the risk of acute myocardial infarction (AMI) among second-generation immigrants in Sweden. Methods: We included all individuals 18 years of age and older in Sweden, n = 4,580,967. AMI was defined as at least one registered diagnosis in the National Patient Register between January 1, 1998, and December 31, 2018. Cox regression analysis was used to estimate the relative risk (hazard ratio = HR) with 99 % confidence interval (CI) of incident AMI with adjustments made for age, sociodemographics, and comorbidities, and also subdivided into two age groups, i.e., 18–54 years and ≥55 years. Results: A total of 158,815 AMI events were registered. Fully adjusted models showed HRs (99 % CI) in second-generation immigrants for men 1.05 (1.01–1.08), and for women 0.99 (0.94–1.05). A marginally higher MI risk was found only among men with parents from the Nordic countries in the fully adjusted model, HR 1.05 (1.01–1.10), and a lower risk only among women with parents from Asian countries, HR 0.47 (0.30–0.75). No significant overall differences in AMI risk were seen in older and younger second-generation immigrants. Conclusions: The overall risk of AMI was similar for most groups of men and women with foreign-born parents compared to native-born Swedes. Our findings suggest that environmental factors may be more important than genetic factors, but further studies are needed to quantify these risks concerning AMI.

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author
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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Acute myocardial infarction, Immigrants, Neighborhood, Sex, Socioeconomic status
in
Atherosclerosis
volume
402
article number
119102
publisher
Elsevier
external identifiers
  • scopus:85215117214
  • pmid:39818459
ISSN
0021-9150
DOI
10.1016/j.atherosclerosis.2024.119102
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2024 The Authors
id
6b614e53-72c9-4cab-b010-ffc44d0bf381
date added to LUP
2025-05-06 10:45:28
date last changed
2025-06-03 13:50:59
@article{6b614e53-72c9-4cab-b010-ffc44d0bf381,
  abstract     = {{<p>Background and aims: Environmental and genetic factors predispose to cardiovascular disease. Some first-generation immigrants have a higher cardiovascular risk in Sweden, while less is known about second-generation immigrants. We aimed to analyze the risk of acute myocardial infarction (AMI) among second-generation immigrants in Sweden. Methods: We included all individuals 18 years of age and older in Sweden, n = 4,580,967. AMI was defined as at least one registered diagnosis in the National Patient Register between January 1, 1998, and December 31, 2018. Cox regression analysis was used to estimate the relative risk (hazard ratio = HR) with 99 % confidence interval (CI) of incident AMI with adjustments made for age, sociodemographics, and comorbidities, and also subdivided into two age groups, i.e., 18–54 years and ≥55 years. Results: A total of 158,815 AMI events were registered. Fully adjusted models showed HRs (99 % CI) in second-generation immigrants for men 1.05 (1.01–1.08), and for women 0.99 (0.94–1.05). A marginally higher MI risk was found only among men with parents from the Nordic countries in the fully adjusted model, HR 1.05 (1.01–1.10), and a lower risk only among women with parents from Asian countries, HR 0.47 (0.30–0.75). No significant overall differences in AMI risk were seen in older and younger second-generation immigrants. Conclusions: The overall risk of AMI was similar for most groups of men and women with foreign-born parents compared to native-born Swedes. Our findings suggest that environmental factors may be more important than genetic factors, but further studies are needed to quantify these risks concerning AMI.</p>}},
  author       = {{Wändell, Per and Li, Xinjun and Carlsson, Axel C. and Sundquist, Jan and Sundquist, Kristina}},
  issn         = {{0021-9150}},
  keywords     = {{Acute myocardial infarction; Immigrants; Neighborhood; Sex; Socioeconomic status}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Atherosclerosis}},
  title        = {{Myocardial infarction in second-generation immigrants compared to native-born Swedes in the total population of Sweden}},
  url          = {{http://dx.doi.org/10.1016/j.atherosclerosis.2024.119102}},
  doi          = {{10.1016/j.atherosclerosis.2024.119102}},
  volume       = {{402}},
  year         = {{2025}},
}