ST‐elevation myocardial infarction in a migrant population: a registry‐based study of patient treatment and outcomes

Rye, E.; Lee, Andrea; Mukhtar, H; Narayan, Arun; Denniss, A. Robert; Chow, Clara K; Kovoor, Pramesh; Sivagangabalan, Gopal

doi:10.1111/imj.14084

Cited by 3 publications

(4 citation statements)

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“…We identified 1,184 publications through the literature search and screened them, 281 of which were duplicates. A total of 903 articles and an additional 9 articles identified by manual searches for references of included studies were screened by title and abstract, of which 35 were included in full-text screening, and 6 studies finally met the inclusion criteria ( 18 – 23 ). The reasons for exclusion are classified and given in Figure 1 .…”

Section: Resultsmentioning

confidence: 99%

“…The characteristics of the included studies are shown in Table 1 . Using NOS to assess the quality of the 6 included studies, five studies ( 19 – 23 ) received a high-quality rating, and one study ( 18 ) received a moderate-quality rating. Overall, the qualities of the included studies were good.…”

Section: Resultsmentioning

confidence: 99%

“…The pooled adjusted short-term mortality rate did not show significant differences between migrants and natives, and there are several possible reasons for this. The first may be due to the major advances in the treatment of MI, evidence shows that migrants do not differ from natives in terms of key in-hospital treatments, including rates of reperfusion therapy and door-to-balloon time, and no significant differences were observed in length of hospital stay, in-hospital complications, or mortality ( 18 , 39 – 42 ). Although migrants are disadvantaged in terms of socioeconomic factors and psychological distress, high quality and homogeneous in-hospital care reduces these disparities, and the short follow-up period may not be sufficient to show a difference in the short-term prognosis of migrants compared to natives.…”

Section: Discussionmentioning

confidence: 99%

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The mortality risk after myocardial infraction in migrants compared with natives: a systematic review and meta-analysis

Zhu

Huang

Chen

2023

Front. Cardiovasc. Med.

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Background and ObjectiveThe evidence on the risk of mortality after myocardial infarction (MI) among migrants compared with natives is mixed and limited. The aim of this study is to assess the mortality risk after MI in migrants compared to natives.MethodsThis study protocol is registered with PROSPERO, number CRD42022350876. We searched the Medline and Embase databases, without time and language constraints, for cohort studies that reported the risk of mortality after MI in migrants compared to natives. The migration status is confirmed by country of birth, both migrants and natives are general terms and are not restricted to a particular country or area of destination or origin. Two reviewers separately screened searched studies according to selection criteria, extracted data, and assessed data quality using the Newcastle-Ottawa Scale (NOS) and risk of bias of included studies. Pooled estimates of adjusted and unadjusted mortality after MI were calculated separately using a random-effects model, and subgroup analysis was performed by region of origin and follow-up time.ResultA total of 6 studies were enrolled, including 34,835 migrants and 284,629 natives. The pooled adjusted all-cause mortality of migrants after MI was higher than that of natives (OR, 1.24; 95% CI, 1.10–1.39; I2 = 83.1%), while the the pooled unadjusted mortality of migrants after MI was not significantly different from that of natives (OR, 1.11; 95% CI, 0.69–1.79; I2 = 99.3%). In subgroup analyses, adjusted 5–10 years mortality (3 studies) was higher in the migrant population (OR, 1.27; 95% CI, 1.12–1.45; I2 = 86.8%), while adjusted 30 days (4 studies) and 1–3 years (3 studies) mortality were not significantly different between the two groups. Migrants from Europe (4 studies) (OR, 1.34; 95% CI, 1.16–1.55; I2 = 39%), Africa (3 studies) (OR, 1.50; 95% CI, 01.31–1.72; I2 = 0%), and Latin America (2 studies) (OR, 1.44; 95% CI, 1.30–1.60; I2 = 0%) had significantly higher rates of post-MI mortality than natives, with the exception of migrants of Asian origin (4 studies) (OR, 1.20; 95% CI, 0.99–1.46; I2 = 72.7%).ConclusionsMigrants tend to have lower socioeconomic status, greater psychological stress, less social support, limited access to health care resources, etc., therefore, face a higher risk of mortality after MI in the long term compared to natives. Further research is needed to confirm our conclusions, and more attention should be paid to the cardiovascular health of migrants.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier: r CRD42022350876.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The mortality risk after myocardial infraction in migrants compared with natives: a systematic review and meta-analysis

Zhu

Huang

Chen

2023

Front. Cardiovasc. Med.

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“…Variations in characteristics (e.g., age, education level, socioeconomic status), symptoms (e.g., symptom recognition, perception of pain, severity of pain), and outcomes (e.g., mortality rate, readmission rate) among ethnic groups have been reported in previous studies [6][7][8]. Rye et al [9] reported a higher risk of cardiovascular and comorbidity among migrants compared to Australian-born patients [9]. One study revealed a low level of awareness of myocardial infarction (MI) symptoms and inappropriate response to MI symptoms among migrants in the USA [10].…”

Section: Introductionmentioning

confidence: 86%

Variation in Seeking Care for Cardiovascular Disease and Ambulance Utilization among Migrants in Australia: Time, Ethnicity, and Delay (TED) Study III

Wechkunanukul

Ullah

Beilby

2022

IJERPH

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Insight into differences in seeking medical care for chest pain among migrant populations is limited. This study aimed to determine ethnic differences in seeking care behaviors and using ambulances among migrants compared to an Australian-born group. A total of 607 patients presenting with chest pain to a tertiary hospital between 1 July 2012 and 30 June 2014 were randomly selected. Data from the emergency department dataset and medical record reviews were collected and linked for analysis. The migrant group was stratified into nine ethnic groups for analysis based on the Australian Standard Classification of Cultural and Ethnic Groups. The overall median prehospital delay time was 3.7 (1.5, 10.7) hours, which ranged from 2.5 (1.0, 10.7) (Southern and Eastern European group) to 6.0 (2.3, 20.6) (Sub-Saharan African group). The median decision time was 2.0 (0.8, 7.9) hours, which ranged from 1.5 (Australian-born group) to 4.5 h (Sub-Saharan African group). Five ethnic groups had significantly longer decision times compared to the Australian-born group. Decision time accounted for 58.4% of pre-hospital delay time. Migrant patients were 60% less likely to seek care for chest pain within one hour (odds ratio 0.40, (0.23–0.68), p = 0.001). There was no significant difference in ambulance utilization between migrant and Australian-born groups. In conclusion, ethnic differences in seeking care for chest pain do exist, and ethnicity plays a vital role in a longer delay in seeking care. To reduce the delays and improve patient outcomes, appropriate health campaigns focusing on ethnic differences among migrant populations and normalizing cultural competency into practice are recommended.

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Features of acute coronary syndrome in migrant workers

Shchepetin,

Chuvarayan,

Orlova

et al. 2024

Medicinskij alfavit

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Cardiovascular diseases of migrant workers are an additional burden on the health care system of many countries in Europe, the United States, and Russia. The prevalence of risk factors among migrants is associated with the country of origin of migrants, the duration of migration, low socioeconomic conditions of residence in the host country, psychological stress, significant physical exertion, violations of work and rest, malnutrition, the spread of harmful factors (smoking, alcohol, narcotic substances), limited access to medical services. The results of the study are presented, indicating that smoking is more common among migrant workers, hypertension levels, total cholesterol, triglycerides, high-density lipoproteins, and low-density lipoproteins are higher in comparison with the indigenous inhabitants of Russia. When performing coronary angiography in patients with acute coronary syndrome in migrant workers, despite their younger age, several vascular lesions are significantly more often detected. The data of the conducted study demonstrate high risks of cardiovascular diseases among migrant workers, which requires organizational measures to prevent them.

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ST‐elevation myocardial infarction in a migrant population: a registry‐based study of patient treatment and outcomes

Cited by 3 publications

References 54 publications

The mortality risk after myocardial infraction in migrants compared with natives: a systematic review and meta-analysis

The mortality risk after myocardial infraction in migrants compared with natives: a systematic review and meta-analysis

Variation in Seeking Care for Cardiovascular Disease and Ambulance Utilization among Migrants in Australia: Time, Ethnicity, and Delay (TED) Study III

Features of acute coronary syndrome in migrant workers

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