Article open access publication

Differences in initiation and discontinuation of preventive medications and use of non-pharmacological interventions after acute coronary syndrome among migrants and Danish-born.

European Heart Journal, Oxford University Press (OUP), ISSN 1522-9645

Volume 39, 25, 2018

DOI:10.1093/eurheartj/ehy227, Dimensions: pub.1103362529, PMID: 29718168,



  1. (1) University College Capital, grid.460779.b
  2. (2) Department of Internal Medicine, Copenhagen University Hospital, Herlev, Herlev ringvej 75, Herlev, Denmark.
  3. (3) University of Copenhagen, grid.5254.6, KU
  4. (4) Odense University Hospital, grid.7143.1, Southern Denmark Region
  5. (5) University of Southern Denmark, grid.10825.3e, SDU
  6. (6) Aarhus University Hospital, grid.154185.c, Central Denmark Region






Aims: The aim of this article is to assess initiation and discontinuation of preventive medication and use of non-pharmacological prevention interventions after acute coronary syndrome (ACS) among migrants to Denmark compared to the local-born Danish population, taking differences in comorbidity and sociodemographic factors into account. Methods and results: In this large cohort study, we selected the population (n = 33 199) from nationwide registers and followed each individual among migrants and Danish-born 180 days after ACS. We identified the initiation and discontinuation of medications and the initiation and number of contacts for non-pharmacological interventions in the Register of Medicinal Products Statistics and the National Patient Register, and adjusted for comorbidity and sociodemographic factors. Non-Western migrants had lower relative risks for initiating adenosine diphosphate receptor (ADP)- and angiotensin-converting enzyme (ACE)-inhibitors (0.93, CI: 0.90; 0.96, and 0.91, CI: 0.87; 0.96) and patient education (0.95, CI: 0.92; 0.98). Further, non-Western migrants had higher hazard ratios for discontinuing medications (statins: 1.64, CI: 1.45; 1.86, ADP-inhibitors: 1.72, CI: 1.50; 1.97, β-blockers: 1.52, CI: 1.40; 1.64, and ACE-inhibitors: 1.72, CI: 1.46; 2.02), and fewer contacts for physical exercise and patient education (P < 0.001 and P = 0.011). Conclusion: We identified differences between non-Western migrants and Danish-born in initiation and discontinuation of preventive medications and use of non-pharmacological interventions after ACS. These differences could not be explained by differences in comorbidity or sociodemographic factors.


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Field Citation Ratio (FCR): 4.46

Relative Citation ratio (RCR): 1.12

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