title: Recommended drug use after acute myocardial infarction by migration status and education level.
abstract: OBJECTIVE
  The purpose of this study is to investigate the association between migration status and education level and the use of recommended drugs after first acute myocardial infarction (MI).
  
  
  METHODS
  A nationwide cohort study performed in Sweden from January 1, 2006 to August 1, 2008. The cohort consisted of 49,037 incident cases of first acute MI. In total, 37,570 individuals survived 180 days after MI, of whom 4782 (12.7%) were foreign-born. We used logistic regression to estimate the odds ratio (OR) with 95% confidence interval (CI) of the association between migration status and education level and prescribed drugs after MI.
  
  
  RESULTS
  One third of the patients who were not on any recommended cardiovascular drugs before MI continued to be without recommended cardiovascular drugs after MI. Among those with no cardiovascular drugs before MI, we found no difference in recommended drug use after MI by migration status (OR 1.00, 95% CI 0.89-1.12). Among those with some but not all recommended cardiovascular drugs before MI, foreign-born cases had a slightly non-significant lower use of recommended drugs (OR 0.92, 95% CI 0.83-1.03). Foreign-born patients with low education had a slightly lower use of recommended drug compared to Sweden-born. Women with low education had a lower use of drugs after MI (Sweden born, OR 0.85; 95% CI 0.74-0.96 and foreign born OR 0.51; 95% CI 0.34-0.77).
  
  
  CONCLUSIONS
  There is no apparent difference between foreign-born and Sweden-born in recommended drug use after MI. However, our study reveals an inequity in secondary prevention therapy after myocardial infarction by education level.
authors.affiliation: Institute of Environmental Medicine, Unit of Cardiovascular Epidemiology, Karolinska Institutet, Nobels väg 13, Box 210, 171 77, Stockholm, Sweden, dashti.dzayee@ki.se.
authors.forename: Dashti Ali Mustafa
authors.initials: DA
authors.lastname: Dzayee
authors.forename: Tahereh
authors.initials: T
authors.lastname: Moradi
authors.forename: Omid
authors.initials: O
authors.lastname: Beiki
authors.forename: Lars
authors.initials: L
authors.lastname: Alfredsson
authors.forename: Rickard
authors.initials: R
authors.lastname: Ljung
mesh_terms: D000208:Acute Disease / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D004522:Educational Status; D054242:Emigrants and Immigrants; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy*; D016017:Odds Ratio; D055553:Prescription Drugs / Q000627:therapeutic use*; D055502:Secondary Prevention; D012737:Sex Factors; D012923:Social Class; D013548:Sweden
chemical_list: D002317:Cardiovascular Agents; D055553:Prescription Drugs