title: Different patterns of association between education and wealth with non-fatal myocardial infarction in Tehran, Iran: A population-based case-control study.
abstract: BACKGROUND
  Myocardial Infarction (MI) is a main cause of death and disability worldwide, which involves a number of genetic, physiopathologic and socio-economic determinants. The aim of this study was to assess the patterns of association between education, wealth and some other risk factors with non-fatal MI in Tehran population.
  
  
  METHODS
  Data derived from a second round of large cross-sectional study, Urban HEART-2, conducted in Tehran in 2011. Out of 118542 participants, all 249 self-reported incident cases of nonfatal MI were selected as the case group. A number of 996, matched on age and sex, were selected as controls. Principle component analysis (PCA) was used to calculate wealth index and logistic regression model to assess relations between the study variables.
  
  
  RESULTS
  Mean (SD) age of participants was 60.25 (12.26) years. A total of 870 (69.9%) of the study subjects were men. Education, wealth status, family violence, hypertension and diabetes were observed as independent predictors of non-fatal MI. Overall, as the level of education increased, the odds of non-fatal MI decreased (p<0.001). We observed an almost J-shaped association between wealth status and non-fatal MI. No significant associations were found between marital status, BMI and current smoking with non-fatal MI (p<0.05).
  
  
  CONCLUSIONS
  We found different patterns of association between education and wealth with nonfatal MI among Tehran adults. Lower risk of non-fatal MI is linked to high educated groups whereas economically moderate group has the lowest risk of non-fatal MI occurrence.
authors.affiliation: PhD student in Epidemiology, Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran. cheraghian2000@yahoo.com.
authors.forename: Bahman
authors.initials: B
authors.lastname: Cheraghian
authors.affiliation: Associate Professor in Epidemiology, Department of Epidemiology and Biostatistics, School of Public Health, Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran. nejatsan@tums.ac.ir.
authors.forename: Saharnaz
authors.initials: S
authors.lastname: Nedjat
authors.affiliation: Assistant professor, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. Mansournia_ma@yahoo.com.
authors.forename: Mohammad Ali
authors.initials: MA
authors.lastname: Mansournia
authors.affiliation: Professor, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. rezamajd@ tums.ac.ir.
authors.forename: Reza
authors.initials: R
authors.lastname: Majdzadeh
authors.affiliation: Professor, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. mohamadk@ tums.ac.ir.
authors.forename: Kazem
authors.initials: K
authors.lastname: Mohammad
authors.affiliation: Professor, Department of Physiology, Shahed University, Tehran, Iran. vaezmahdavi@shahed.ac.ir.
authors.forename: Mohammad Reza
authors.initials: MR
authors.lastname: Vaez-Mahdavi
authors.affiliation: Professor, Department of Social Medicine, Faculty of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran. faghihz@modares.ac.ir.
authors.forename: Soghrat
authors.initials: S
authors.lastname: Faghihzadeh
authors.affiliation: Research Instructor, Health Education & Promotion Research Group, Health Metrics Research Center, Iranian Institute for Health Sciences Research (IHSR), ACECR, Tehran, Iran. Haeri.stat@gmail.com.
authors.forename: Ali Asghar
authors.initials: AA
authors.lastname: Haeri Mehrizi
authors.affiliation: Associate Professor, Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran & Oncopathology Research Centre, Tehran, Iran. Mohsen.asadi@yahoo.com .
authors.forename: Mohsen
authors.initials: M
authors.lastname: Asadi-Lari
keywords: Case-control; Education; Iran; Myocardial infarction; Wealth