Department of Medicine, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
QJM. 2010 Apr;103(4):253-8. doi: 10.1093/qjmed/hcq006. Epub 2010 Feb 18.
New immigrants to North America exhibit lower rates of obesity and hypertension than their native-born counterparts. Whether this is reflected by a lower relative risk of acute myocardial infarction (AMI) is not known.
To determine the risk of AMI among new immigrants compared to long-term residents, and, among those who develop AMI, their short- and long-term mortality rate.
Population-based, matched, retrospective cohort study.
Entire province of Ontario, the most populated province in Canada, from 1 April 1995 to 31 March 2007.
A total of 965,829 new immigrants were matched to 3,272,393 long-term residents by year of birth, sex and geographic location.
The main study outcome was hospitalization with a most responsible diagnosis of AMI. Secondary study outcomes among those who sustained an AMI were in-hospital, 30-day and 1-year mortality.
The mean age of the participants at study entry was approximately 34 years. The incidence rate of AMI was 4.14 per 10,000 person-years among new immigrants and 6.61 per 10,000 person-years among long-term residents. After adjusting for age, income quintile, urban vs. rural residence, history of hypertension, diabetes mellitus and smoking and number of health insurance claims, the hazard ratio for AMI was 0.66 [95% confidence interval (CI): 0.63-0.69].
New immigrants appear to be at lower risk of AMI than long-term residents. This finding does not appear to be explained by the availability of health-care services or income level.
新移民到北美的肥胖症和高血压发病率低于其本土出生的同龄人。这是否反映在急性心肌梗死（AMI）的相对风险较低还不得而知。
确定新移民与长期居民相比发生 AMI 的风险，以及在发生 AMI 的人群中，他们的短期和长期死亡率。
基于人群、匹配、回顾性队列研究。
整个安大略省，加拿大人口最多的省份，从 1995 年 4 月 1 日至 2007 年 3 月 31 日。
共有 965829 名新移民与 3272393 名长期居民通过出生年份、性别和地理位置相匹配。
主要研究结果是因 AMI 而住院治疗的诊断。在发生 AMI 的人群中，次要研究结果是住院期间、30 天和 1 年的死亡率。
参与者在研究开始时的平均年龄约为 34 岁。新移民的 AMI 发病率为每 10000 人年 4.14 例，长期居民为每 10000 人年 6.61 例。调整年龄、收入五分位数、城乡居住、高血压、糖尿病和吸烟史以及医疗保险索赔次数后，AMI 的风险比为 0.66（95%置信区间：0.63-0.69）。
新移民似乎患 AMI 的风险低于长期居民。这一发现似乎不能用医疗保健服务的可及性或收入水平来解释。
