title: Prognosis after a first hospitalisation for acute myocardial infarction and congestive heart failure by country of birth.
abstract: OBJECTIVE
  To investigate differences in 28-day and 5-year mortality and 5-year readmission after a first hospitalisation for acute myocardial infarction (AMI) and congestive heart failure (CHF) between first generation ethnic minority groups (henceforth, migrants) and the ethnic Dutch population.
  
  
  METHODS
  Nationwide prospective cohorts of first hospitalised AMI (N=213 630) and CHF patients (N=189 069) between 1998 and 2010 were built. Differences in 28-day and 5-year mortality and in 5-year AMI/CHF readmission between migrants (Surinamese, Moroccan, Turkish, Antillean, Indonesian, Chinese and South Asian) and the ethnic Dutch population were investigated using Cox proportional hazard regression models.
  
  
  RESULTS
  After the first AMI hospitalisation, mortality and AMI/CHF readmission were higher in the majority of migrant groups compared with ethnic Dutch. For example, HRs (adjusted for age, sex, marital status, degree of urbanisation and year of event) with 95% CIs among Surinamese (mainly of African or South-Asian origin) were 1.16 (1.02 to 1.32) for 28-day mortality, 1.44 (1.30 to 1.60) for 5-year mortality, 1.33 (1.08 to 1.63) for AMI readmission and 2.09 (1.82 to 2.40) for CHF readmission. After a first CHF hospitalisation, mortality rates among migrants were more diverse, with lower 28-day mortality among Moroccan and Turkish migrants and higher 5-year mortality among Surinamese, Chinese and South Asians. Readmission after CHF was often higher among migrant groups.
  
  
  CONCLUSIONS
  Prognosis after a first AMI hospitalisation was worse among most migrant groups compared with the ethnic Dutch population. Ethnic inequalities in prognosis after a first CHF hospitalisation were more diverse. Efforts should be made to disentangle the underlying factors of the results.
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: A A M
authors.initials: AA
authors.lastname: van Oeffelen
authors.affiliation: Department of Social Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: C
authors.initials: C
authors.lastname: Agyemang
authors.affiliation: Department of Social Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: K
authors.initials: K
authors.lastname: Stronks
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: M L
authors.initials: ML
authors.lastname: Bots
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: I
authors.initials: I
authors.lastname: Vaartjes
mesh_terms: D000328:Adult; D000368:Aged; D001208:Asia / Q000208:ethnology; D044466:Asian People; D044383:Black People; D054242:Emigrants and Immigrants; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities / Q000208:ethnology; D006333:Heart Failure / Q000175:diagnosis / Q000208:ethnology* / Q000401:mortality / Q000628:therapy; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009018:Morocco / Q000208:ethnology; D009203:Myocardial Infarction / Q000175:diagnosis / Q000208:ethnology* / Q000401:mortality / Q000628:therapy; D009426:Netherlands / Q000453:epidemiology; D009427:Netherlands Antilles / Q000208:ethnology; D010359:Patient Readmission; D011379:Prognosis; D016016:Proportional Hazards Models; D012042:Registries; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors
keywords: CORONARY ARTERY DISEASE; HEART FAILURE; MYOCARDIAL ISCHAEMIA AND INFARCTION (IHD)