Background. Disparities among ethnic groups are reported in the epidemiology and outcomes of cardiovascular diseases. Given the growing prevalence of migrant populations in Italy and the “epidemic” of cardiovascular diseases, the aim of this study was to evaluate the characteristics and outcomes of patients with acute coronary syndrome (ACS) in relation to country of origin. Methods. This retrospective study includes patients living in Emilia-Romagna, Italy, and discharged from 2012 to 2014 with a diagnosis of acute myocardial infarction (AMI, STEMI and non-STEMI). Primary outcomes were percutaneous coronary intervention (PTCA) within 48 hours of admission for STEMI and 30-day all-cause mortality, and secondary outcomes 1-year adherence to post-AMI medications, major adverse cardiac and cerebrovascular event (MACCE) and all-cause mortality. The relationship between outcomes and citizenship was analyzed using multiple regression models. Potential confounders were age, gender and comorbidities recorded in the index and prior two years hospitalizations. Results. The study population comprised 23,884 patients of which 647 (2.7%) are migrants. The mean age of onset of ACS was lower among migrants than among Italians (56 vs 73 years) and immigrants had a higher prevalence of STEMI (50.1% vs 44.9%; χ2 = 6.8, p = 0.009). Compared with Italians, patients from Africa and Asia had a lower likelihood of undergoing PTCA and were less adherent to medications. Adjusted mortality rates were similar between Italians and migrants, however patients from Asia had a 62% increased probability of experiencing a MACCE at 1 year. Conclusions. Migrants with ACS were younger, less likely to undergo PTCA, and less adherent to drug treatment after discharge compared with Italians. Further studies are needed to investigate in depth the determinants of these differences and to develop organizational models tailored to the specific needs of migrant patients.
Characteristics and outcomes of acute coronary syndrome in migrant and Italian-born population / Fantini, Mp; Avaldi, Vm; Di Pasquale, G; Fioritti, A; Rucci, P; Lenzi, J.. - In: EUROPEAN JOURNAL OF PUBLIC HEALTH. - ISSN 1101-1262. - ELETTRONICO. - 27:Supplement 3(2017), pp. 98-99. (Intervento presentato al convegno 10th European Public Health Conference tenutosi a Stoccolma, Svezia nel 1–4 novembre 2017) [10.1093/eurpub/ckx187.252].
Characteristics and outcomes of acute coronary syndrome in migrant and Italian-born population
Fantini, MP
;Avaldi, VM;Di Pasquale, G;Fioritti, A;Rucci, P;Lenzi, J.
2017
Abstract
Background. Disparities among ethnic groups are reported in the epidemiology and outcomes of cardiovascular diseases. Given the growing prevalence of migrant populations in Italy and the “epidemic” of cardiovascular diseases, the aim of this study was to evaluate the characteristics and outcomes of patients with acute coronary syndrome (ACS) in relation to country of origin. Methods. This retrospective study includes patients living in Emilia-Romagna, Italy, and discharged from 2012 to 2014 with a diagnosis of acute myocardial infarction (AMI, STEMI and non-STEMI). Primary outcomes were percutaneous coronary intervention (PTCA) within 48 hours of admission for STEMI and 30-day all-cause mortality, and secondary outcomes 1-year adherence to post-AMI medications, major adverse cardiac and cerebrovascular event (MACCE) and all-cause mortality. The relationship between outcomes and citizenship was analyzed using multiple regression models. Potential confounders were age, gender and comorbidities recorded in the index and prior two years hospitalizations. Results. The study population comprised 23,884 patients of which 647 (2.7%) are migrants. The mean age of onset of ACS was lower among migrants than among Italians (56 vs 73 years) and immigrants had a higher prevalence of STEMI (50.1% vs 44.9%; χ2 = 6.8, p = 0.009). Compared with Italians, patients from Africa and Asia had a lower likelihood of undergoing PTCA and were less adherent to medications. Adjusted mortality rates were similar between Italians and migrants, however patients from Asia had a 62% increased probability of experiencing a MACCE at 1 year. Conclusions. Migrants with ACS were younger, less likely to undergo PTCA, and less adherent to drug treatment after discharge compared with Italians. Further studies are needed to investigate in depth the determinants of these differences and to develop organizational models tailored to the specific needs of migrant patients.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
