[The treatment of acute myocardial infarction among new immigrants in Israel].
BACKGROUND
We hypothesized that recent immigrants presenting with a poor cardiac profile may have a worse outcome after acute myocardial infarction compared with veteran Israelis.


METHODS
Of 1,490 consecutive acute myocardial infarction patients investigated in a 2-month survey conducted in 2002, 256 had immigrated since January 1990 and 1,234 were veteran Israelis.


RESULTS
Recent immigrants were older with a higher percentage of women compared with veteran Israelis (mean age 67.5 vs. 63.6 years, and 30 vs. 21%, p<0.001 respectively). More recent immigrants had hypertension (60%), higher total cholesterol (201 mg/dl) and prior angina (40%) compared to counterparts (45%; 194 mg/dl; 30%, p<0.01 respectively). Previous coronary interventions (7.4%) and coronary bypasses (4.3%) had been performed less frequently in recent immigrants, compared with veteran Israelis (13.8 and 8.3%, p<0.03 respectively). There were no differences between the two groups regarding thrombolysis, primary PCI, coronary angiography, IIb/IIIa and Clopidogrel treatment. Higher 7-day (6.3 vs. 4.1%), 30 day (9.0 vs. 6.3%), 6-month (14.1 vs. 10.0%), p<0.05 and 1-year mortality (18.0 vs. 11.7%, p<0.006) were observed along recent immigrants compared to veteran Israelis, respectively. Trend for increased mortality among recent immigrants may be explained by significant age and gender differences and co morbidity. After multiple adjustment for age, sex, prior angina, hypertension, prior PCI, CABG and Killip class 1I+, mortality rates among recent immigrants were not different from veteran Israelis.


CONCLUSIONS
In a national acute myocardial infarction survey, recent immigrants were found to have a more adverse coronary profile than veteran Israeli patients, but were treated comparably and exhibited the same short-term prognosis.
Brodov
Y
Y
The Israeli association for prevention of Myocardial Infarction, Heart Institute Neufeld, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel. brodov_y@bezeqint.net
Sandach
A
A
Behar
S
S
D000368:Aged; D000787:Angina Pectoris / Q000453:epidemiology; D004641:Emigration and Immigration / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D007557:Israel / Q000453:epidemiology; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology* / Q000628:therapy; D012744:Sex Ratio