Comparative analysis of acute coronary syndrome outcome: immigrants vs. residents in a monocentric STEMI network

Differences in prevalence of cardiovascular risk factors, prevention of cardiovascular disease and cardiovascular outcomes in migrants are well established when compared with host populations. Less is known, however, with respect to acute coronary syndrome (ACS), its occurrence and possible differences in management and outcome in immigrant populations. We therefore aimed in this study to assess in a comparative analysis possible differences in the occurrence and outcome of ACS between immigrants and the host population in a real-world setting.

Patients urgently admitted to the acute cardiac care unit (ACCU) for ACS were included in the study: in-hospital survival outcome was analyzed and immigrants were compared with the resident population.

A total of 1199 consecutive patients were enrolled in the 2.5 years of the study: 40 (3.3%) were immigrants, mortality rate was 2.6%, mean hospital stay 7.7 ± 6 days. Hospitalized immigrants for ACS were in 65% of cases Eastern Europeans, 20% North-Africans-Middle-Easterns. Annual incidence of hospitalization in the ACCU for ACS was 0.18% in immigrants vs. 0.30% in residents (P = 0.0010); in-hospital death rates were comparable (2.5% vs. 2.6%, P = n.s.). When split for background world region, mortality rates were highest in the Eastern-Europe an women (10%, P = n.s.).

In an observational study on ACCU hospitalized ACS patients, ACS occurrence was lower in immigrants when compared with residents, while clinical outcomes were comparable. Among immigrants, worse prognosis and higher female prevalence were observed in the Eastern-European group; less ACS was found among women from Africa and the Middle East.