title: Religious observance and acute coronary syndrome in predominantly Muslim Albania: a population-based case-control study in Tirana.
abstract: OBJECTIVE
  We aimed to assess the association of religious observance with acute coronary syndrome (ACS) in a predominantly Muslim population.
  
  
  METHODS
  A case-control study conducted in Tirana, Albania in 2003-2006 included 467 nonfatal consecutive ACS patients (370 men, 97 women; 88% response) and a population-based control group (469 men, 268 women; 69% response). Religious observance was assessed as a composite score based on mosque/church attendance, frequency of prayer and ritual fasting. The association of religiosity with ACS was assessed by multivariable-adjusted logistic regression.
  
  
  RESULTS
  Nonobservance was frequent in this population (67% among Muslim controls, 55% in Christian controls). Religious observance was inversely associated with ACS in both groups (multivariable-adjusted odds ratios for above median observance scores vs zero observance: 0.45 [95% confidence interval (CI) = 0.26-0.77] in Muslims, 0.58 [0.25-1.31] in Christians, and 0.48 [0.31-0.74] overall]. Associations with ACS were strongest for prayer and fasting.
  
  
  CONCLUSIONS
  In a country experiencing major socioeconomic transition from rigid communism, including extreme state-enforced secularism, we found an apparent protective effect associated with religious observance in both Muslims and Christians. This may be the first such study reported in a Muslim population.
authors.affiliation: Department of Public Health, Faculty of Medicine, University Hospital Centre Mother Teresa, Tirana, Albania. gburazeri@yahoo.com
authors.forename: Genc
authors.initials: G
authors.lastname: Burazeri
authors.forename: Artan
authors.initials: A
authors.lastname: Goda
authors.forename: Jeremy D
authors.initials: JD
authors.lastname: Kark
mesh_terms: D054058:Acute Coronary Syndrome / Q000453:epidemiology* / Q000208:ethnology; D000328:Adult; D000368:Aged; D000415:Albania / Q000453:epidemiology; D016022:Case-Control Studies; D002835:Christianity; D004651:Employment; D005260:Female; D006801:Humans; D007514:Islam; D008019:Life Style; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012959:Socioeconomic Factors; D029181:Spirituality