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

IF 4.9 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS Atherosclerosis Pub Date : 2024-12-26 DOI:10.1016/j.atherosclerosis.2024.119102

Per Wändell, Xinjun Li, Axel C Carlsson, Jan Sundquist, Kristina Sundquist

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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, 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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与瑞典总人口中本土出生的瑞典人相比，第二代移民的心肌梗死。

背景和目的：环境和遗传因素易导致心血管疾病。在瑞典，一些第一代移民有较高的心血管风险，而对第二代移民知之甚少。我们的目的是分析瑞典第二代移民发生急性心肌梗死（AMI）的风险。方法：我们纳入了瑞典所有18岁及以上的个体，n = 4,580,967。AMI被定义为1998年1月1日至2018年12月31日期间在国家患者登记册中至少有一种注册诊断。经年龄、社会人口统计学和合并症等因素调整后，采用Cox回归分析估计AMI发生的相对危险度（风险比= HR）， CI为99%，并将其细分为18-54岁和≥55岁两个年龄组。结果：共登记AMI事件158,815例。完全调整后的模型显示，第二代移民男性的hr （99% CI）为1.05(1.01-1.08)，女性为0.99（0.94-1.05）。在完全调整的模型中，只有父母来自北欧国家的男性心肌梗死风险略高，HR为1.05(1.01-1.10)，只有父母来自亚洲国家的女性心肌梗死风险较低，HR为0.47（0.30-0.75）。在老年和年轻的第二代移民中，AMI风险没有明显的总体差异。结论：与本地出生的瑞典人相比，大多数外国出生父母的男性和女性AMI的总体风险相似。我们的研究结果表明，环境因素可能比遗传因素更重要，但需要进一步的研究来量化这些与AMI有关的风险。

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来源期刊

Atherosclerosis 医学-外周血管病

CiteScore

9.80

自引率

3.80%

发文量

1269

审稿时长

36 days

期刊介绍： Atherosclerosis has an open access mirror journal Atherosclerosis: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. Atherosclerosis brings together, from all sources, papers concerned with investigation on atherosclerosis, its risk factors and clinical manifestations. Atherosclerosis covers basic and translational, clinical and population research approaches to arterial and vascular biology and disease, as well as their risk factors including: disturbances of lipid and lipoprotein metabolism, diabetes and hypertension, thrombosis, and inflammation. The Editors are interested in original or review papers dealing with the pathogenesis, environmental, genetic and epigenetic basis, diagnosis or treatment of atherosclerosis and related diseases as well as their risk factors.