Per Wändell1, Axel C Carlsson1, Xinjun Li2, Danijela Gasevic3,4, Johan Ärnlöv1,5, Martin J Holzmann6,7, Jan Sundquist2,8,9, Kristina Sundquist2,8,9. 1. Division of Family Medicine and Primary Care, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Huddinge, Sweden. 2. Center for Primary Health Care Research, Lund University, Malmö, Sweden. 3. Usher Institute of Population Health Sciences and Informatics, College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK. 4. School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia. 5. School of Health and Social Studies, Dalarna University, Falun, Sweden. 6. Functional Area of Emergency Medicine, Karolinska University Hospital, Huddinge, Sweden. 7. Department of Internal Medicine Solna, Karolinska Institutet, Stockholm, Sweden. 8. Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA. 9. Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Japan.
Abstract
AIM: To study association between country of birth and risk of first-onset atrial fibrillation (AF) in first- and second-generation immigrants to Sweden under 45 y of age. METHODS: The study population included all individuals (n = 3 248 457) under the age of 45 y in Sweden, including immigrants (n = 722 249). AF was defined as first registered diagnosis in the National Patient Register. Association between country of birth and risk of AF was assessed by Cox regression, calculating HRs and 95% CIs, using Swedish-born individuals as referents. All models were stratified by sex, and in different models were adjusted for age, area of residence in Sweden, educational level, marital status, neighbourhood socioeconomic status and co-morbidity(ies). RESULTS: A higher fully adjusted HR of incident AF was found in the total sample of first-generation immigrants, 1.44 (95% CI 1.35 to 1.54), in males born in Denmark, Lebanon and Iraq, and in females born in Turkey and Iraq. Lower HRs were found in male and female immigrants from Latin America and Iran, and female immigrants from Finland. Among second-generation immigrants, the fully adjusted HR was significantly lower, 0.70 (95% CI 0.58 to 0.83). CONCLUSIONS: Clinicians may show a greater awareness of AF in some groups of younger immigrants to enable early diagnosis.
AIM: To study association between country of birth and risk of first-onset atrial fibrillation (AF) in first- and second-generation immigrants to Sweden under 45 y of age. METHODS: The study population included all individuals (n = 3 248 457) under the age of 45 y in Sweden, including immigrants (n = 722 249). AF was defined as first registered diagnosis in the National Patient Register. Association between country of birth and risk of AF was assessed by Cox regression, calculating HRs and 95% CIs, using Swedish-born individuals as referents. All models were stratified by sex, and in different models were adjusted for age, area of residence in Sweden, educational level, marital status, neighbourhood socioeconomic status and co-morbidity(ies). RESULTS: A higher fully adjusted HR of incident AF was found in the total sample of first-generation immigrants, 1.44 (95% CI 1.35 to 1.54), in males born in Denmark, Lebanon and Iraq, and in females born in Turkey and Iraq. Lower HRs were found in male and female immigrants from Latin America and Iran, and female immigrants from Finland. Among second-generation immigrants, the fully adjusted HR was significantly lower, 0.70 (95% CI 0.58 to 0.83). CONCLUSIONS: Clinicians may show a greater awareness of AF in some groups of younger immigrants to enable early diagnosis.
Authors: Alexander Samol; Markus Masin; Reinhold Gellner; Britta Otte; Hermann-Joseph Pavenstädt; Erich Bernd Ringelstein; Holger Reinecke; Johannes Waltenberger; Paulus Kirchhof Journal: Europace Date: 2012-12-20 Impact factor: 5.214
Authors: Jonas F Ludvigsson; Eva Andersson; Anders Ekbom; Maria Feychting; Jeong-Lim Kim; Christina Reuterwall; Mona Heurgren; Petra Otterblad Olausson Journal: BMC Public Health Date: 2011-06-09 Impact factor: 3.295