European Journal of Clinical Pharmacology
Volume 71, Issue 4, 2015, Pages 499-504

Recommended drug use after acute myocardial infarction by migration status and education level (Article)

Dzayee D.A.M.* , Moradi T. , Beiki O. , Alfredsson L. , Ljung R.
  • a Institute of Environmental Medicine, Unit of Cardiovascular Epidemiology, Karolinska Institutet, Nobels väg 13 Box 210, Stockholm, 171 77, Sweden
  • b Institute of Environmental Medicine, Unit of Cardiovascular Epidemiology, Karolinska Institutet, Nobels väg 13 Box 210, Stockholm, 171 77, Sweden, Centrum for Epidemiology and Social Medicine, Healthcare Provision, Stockholm Stockholm County, Sweden
  • c Kermanshah University of Medical Sciences, Kermanshah, Iran, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
  • d Institute of Environmental Medicine, Unit of Cardiovascular Epidemiology, Karolinska Institutet, Nobels väg 13 Box 210, Stockholm, 171 77, Sweden
  • e Institute of Environmental Medicine, Unit of Cardiovascular Epidemiology, Karolinska Institutet, Nobels väg 13 Box 210, Stockholm, 171 77, Sweden

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. © 2015 Springer-Verlag Berlin Heidelberg.

Author Keywords

country of birth Sweden Socioeconomic position (SEP) First myocardial infarction Cardiovascular drugs

Index Keywords

cardiovascular agent educational status birth Myocardial Infarction human sex difference middle aged Odds Ratio Cohort Studies diabetes mellitus priority journal acute disease Aged Logistic Models prescription drug Prescription Drugs prescription marriage Sweden Humans migrant secondary prevention male Emigrants and Immigrants female Aged, 80 and over very elderly socioeconomics Article major clinical study migration Cardiovascular Agents age survival time Sex Factors drug use cohort analysis acute heart infarction statistical model social class
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-84925538525&doi=10.1007%2fs00228-015-1821-3&partnerID=40&md5=5be74ab2d2db55db1bdfd3f97496af05
DOI: 10.1007/s00228-015-1821-3
ISSN: 00316970
Cited by: 1
Original Language: English