Atrial fibrillation in immigrants under the age of 45 y in Sweden

Per Wändell, Axel C. Carlsson, Xinjun Li, Danijela Gasevic, Johan Ärnlöv, Martin Holzmann, Jan Sundquist, Kristina Sundquist

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Aim: To study association between country of birth and risk of first-onset atrial fibrillation (AF) in first- A nd second-generation immigrants to Sweden under 45 y of age. Methods: The study population included all individuals (n = 3 248 457) under the age of 45 y in Sweden, including immigrants (n = 722 249). AF was defined as first registered diagnosis in the National Patient Register. Association between country of birth and risk of AF was assessed by Cox regression, calculating HRs and 95% CIs, using Swedish-born individuals as referents. All models were stratified by sex, and in different models were adjusted for age, area of residence in Sweden, educational level, marital status, neighbourhood socioeconomic status and co-morbidity(ies). Results: A higher fully adjusted HR of incident AF was found in the total sample of first-generation immigrants, 1.44 (95% CI 1.35 to 1.54), in males born in Denmark, Lebanon and Iraq, and in females born in Turkey and Iraq. Lower HRs were found in male and female immigrants from Latin America and Iran, and female immigrants from Finland. Among second-generation immigrants, the fully adjusted HR was significantly lower, 0.70 (95% CI 0.58 to 0.83). Conclusions: Clinicians may show a greater awareness of AF in some groups of younger immigrants to enable early diagnosis.

Original languageEnglish
Pages (from-to)193-202
Number of pages10
JournalInternational Health
Volume11
Issue number3
DOIs
Publication statusPublished - 1 May 2019

Keywords

  • Atrial fibrillation
  • co-morbidity
  • gender
  • younger immigrants

Cite this

Wändell, P., Carlsson, A. C., Li, X., Gasevic, D., Ärnlöv, J., Holzmann, M., ... Sundquist, K. (2019). Atrial fibrillation in immigrants under the age of 45 y in Sweden. International Health, 11(3), 193-202. https://doi.org/10.1093/inthealth/ihy075
Wändell, Per ; Carlsson, Axel C. ; Li, Xinjun ; Gasevic, Danijela ; Ärnlöv, Johan ; Holzmann, Martin ; Sundquist, Jan ; Sundquist, Kristina. / Atrial fibrillation in immigrants under the age of 45 y in Sweden. In: International Health. 2019 ; Vol. 11, No. 3. pp. 193-202.
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abstract = "Aim: To study association between country of birth and risk of first-onset atrial fibrillation (AF) in first- A nd second-generation immigrants to Sweden under 45 y of age. Methods: The study population included all individuals (n = 3 248 457) under the age of 45 y in Sweden, including immigrants (n = 722 249). AF was defined as first registered diagnosis in the National Patient Register. Association between country of birth and risk of AF was assessed by Cox regression, calculating HRs and 95{\%} CIs, using Swedish-born individuals as referents. All models were stratified by sex, and in different models were adjusted for age, area of residence in Sweden, educational level, marital status, neighbourhood socioeconomic status and co-morbidity(ies). Results: A higher fully adjusted HR of incident AF was found in the total sample of first-generation immigrants, 1.44 (95{\%} CI 1.35 to 1.54), in males born in Denmark, Lebanon and Iraq, and in females born in Turkey and Iraq. Lower HRs were found in male and female immigrants from Latin America and Iran, and female immigrants from Finland. Among second-generation immigrants, the fully adjusted HR was significantly lower, 0.70 (95{\%} CI 0.58 to 0.83). Conclusions: Clinicians may show a greater awareness of AF in some groups of younger immigrants to enable early diagnosis.",
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Wändell, P, Carlsson, AC, Li, X, Gasevic, D, Ärnlöv, J, Holzmann, M, Sundquist, J & Sundquist, K 2019, 'Atrial fibrillation in immigrants under the age of 45 y in Sweden' International Health, vol. 11, no. 3, pp. 193-202. https://doi.org/10.1093/inthealth/ihy075

Atrial fibrillation in immigrants under the age of 45 y in Sweden. / Wändell, Per; Carlsson, Axel C.; Li, Xinjun; Gasevic, Danijela; Ärnlöv, Johan; Holzmann, Martin; Sundquist, Jan; Sundquist, Kristina.

In: International Health, Vol. 11, No. 3, 01.05.2019, p. 193-202.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Atrial fibrillation in immigrants under the age of 45 y in Sweden

AU - Wändell, Per

AU - Carlsson, Axel C.

AU - Li, Xinjun

AU - Gasevic, Danijela

AU - Ärnlöv, Johan

AU - Holzmann, Martin

AU - Sundquist, Jan

AU - Sundquist, Kristina

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N2 - Aim: To study association between country of birth and risk of first-onset atrial fibrillation (AF) in first- A nd second-generation immigrants to Sweden under 45 y of age. Methods: The study population included all individuals (n = 3 248 457) under the age of 45 y in Sweden, including immigrants (n = 722 249). AF was defined as first registered diagnosis in the National Patient Register. Association between country of birth and risk of AF was assessed by Cox regression, calculating HRs and 95% CIs, using Swedish-born individuals as referents. All models were stratified by sex, and in different models were adjusted for age, area of residence in Sweden, educational level, marital status, neighbourhood socioeconomic status and co-morbidity(ies). Results: A higher fully adjusted HR of incident AF was found in the total sample of first-generation immigrants, 1.44 (95% CI 1.35 to 1.54), in males born in Denmark, Lebanon and Iraq, and in females born in Turkey and Iraq. Lower HRs were found in male and female immigrants from Latin America and Iran, and female immigrants from Finland. Among second-generation immigrants, the fully adjusted HR was significantly lower, 0.70 (95% CI 0.58 to 0.83). Conclusions: Clinicians may show a greater awareness of AF in some groups of younger immigrants to enable early diagnosis.

AB - Aim: To study association between country of birth and risk of first-onset atrial fibrillation (AF) in first- A nd second-generation immigrants to Sweden under 45 y of age. Methods: The study population included all individuals (n = 3 248 457) under the age of 45 y in Sweden, including immigrants (n = 722 249). AF was defined as first registered diagnosis in the National Patient Register. Association between country of birth and risk of AF was assessed by Cox regression, calculating HRs and 95% CIs, using Swedish-born individuals as referents. All models were stratified by sex, and in different models were adjusted for age, area of residence in Sweden, educational level, marital status, neighbourhood socioeconomic status and co-morbidity(ies). Results: A higher fully adjusted HR of incident AF was found in the total sample of first-generation immigrants, 1.44 (95% CI 1.35 to 1.54), in males born in Denmark, Lebanon and Iraq, and in females born in Turkey and Iraq. Lower HRs were found in male and female immigrants from Latin America and Iran, and female immigrants from Finland. Among second-generation immigrants, the fully adjusted HR was significantly lower, 0.70 (95% CI 0.58 to 0.83). Conclusions: Clinicians may show a greater awareness of AF in some groups of younger immigrants to enable early diagnosis.

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KW - co-morbidity

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M3 - Article

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SP - 193

EP - 202

JO - International Health

JF - International Health

SN - 1876-3413

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Wändell P, Carlsson AC, Li X, Gasevic D, Ärnlöv J, Holzmann M et al. Atrial fibrillation in immigrants under the age of 45 y in Sweden. International Health. 2019 May 1;11(3):193-202. https://doi.org/10.1093/inthealth/ihy075