Abstract
Purpose
The purpose of this study is to investigate the association between migration status and education level and the use of recommended drugs after first acute myocardial infarction (MI).
Methods
A nationwide cohort study performed in Sweden from January 1, 2006 to August 1, 2008. The cohort consisted of 49,037 incident cases of first acute MI. In total, 37,570 individuals survived 180 days after MI, of whom 4782 (12.7 %) were foreign-born. We used logistic regression to estimate the odds ratio (OR) with 95 % confidence interval (CI) of the association between migration status and education level and prescribed drugs after MI.
Results
One third of the patients who were not on any recommended cardiovascular drugs before MI continued to be without recommended cardiovascular drugs after MI. Among those with no cardiovascular drugs before MI, we found no difference in recommended drug use after MI by migration status (OR 1.00, 95 % CI 0.89–1.12). Among those with some but not all recommended cardiovascular drugs before MI, foreign-born cases had a slightly non-significant lower use of recommended drugs (OR 0.92, 95 % CI 0.83–1.03). Foreign-born patients with low education had a slightly lower use of recommended drug compared to Sweden-born. Women with low education had a lower use of drugs after MI (Sweden born, OR 0.85; 95 % CI 0.74–0.96 and foreign born OR 0.51; 95 % CI 0.34–0.77).
Conclusion
There is no apparent difference between foreign-born and Sweden-born in recommended drug use after MI. However, our study reveals an inequity in secondary prevention therapy after myocardial infarction by education level.
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Funding
This study was partially financed by research grants from the Swedish Council for Working Life and Social Research (FAS 2008-1128)(current FORTE). Dashti Ali. M. Dzayee’s doctoral studies are partially financed by a fellowship from the Kurdistan Regional Government/Iraq and the Nanakali Group and Institute of Environmental Medicine (IMM), Karolinska Institutet, Stockholm, Sweden.
Authors’ contributions
Dzayee and Moradi had full access to all of the data in the study and assume responsibility for the integrity of the data. Dzayee and Ljung designed and conceptualized the study, and analyzed and interpreted the data. Moradi collected the data and obtained funding. Dzayee drafted the manuscript and analyzed the statistics. Dzayee, Moradi, Beiki, Alfredsson, and Ljung critically revised the manuscript for important intellectual content. Moradi, Beiki, Alfredsson and Ljung supervised the study.
Conflict of interest
The contents of this article are the responsibility of the authors alone and do not necessarily reflect the views of FAS (FORTE) or the Kurdistan Regional Government/Iraq. Neither FAS (FORTE) nor the Kurdistan Regional Government/Iraq had any role in the design and conduct of the study; collection, analysis, and interpretation of data; or preparation, review, and approval of the manuscript. The authors have no conflict of interest to declare.
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Dzayee, D.A.M., Moradi, T., Beiki, O. et al. Recommended drug use after acute myocardial infarction by migration status and education level. Eur J Clin Pharmacol 71, 499–505 (2015). https://doi.org/10.1007/s00228-015-1821-3
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DOI: https://doi.org/10.1007/s00228-015-1821-3