Abstract TH897: Fatality After Acute Myocardial Infarction in Immigrants Compared to Native Koreans: A Nationwide Population-Based Study

Background: South Korea has been trying to improve early symptom awareness of acute myocardial infarction (AMI) and stroke, focusing primarily on native Koreans. Due to potential gaps in health information, language barriers, and limited access to healthcare, immigrants might face greater difficulties in receiving prompt care for AMI and stroke. This study compared 30-day and 1-year fatality rates after AMI and stroke in immigrants versus the general Korean population. Hypothesis: We hypothesized that foreign-born immigrants in Korea have higher 30-day and 1-year fatality rates after AMI and stroke compared with native Koreans. Methods: We analyzed a cohort of foreign-born immigrants living in Korea for more than 3 months in 2022-2023, enrolled in the National Health Insurance system, who experienced incident or recurrent AMI or stroke. Cases of AMI and stroke among immigrants were identified using the operational definitions developed for national statistics. Standardized fatality rate ratios (SFR) and 95% confidence intervals (CIs) were calculated using indirect standardization, with the 2022 Korean population as the reference. Analyses were performed using the 'stdrate' procedure in SAS 9.4 software. Results: For both 2022 and 2023, the total number of immigrants diagnosed with AMI was 631 and 667, and stroke was 2,148 and 2,210, respectively. The combined mean age for both years was 60.1 ±12.2 years for AMI (women, 17.6%) and 63.0 ±12.2 years for stroke (women, 33.4%). Among immigrants, the 30-day and 1-year fatality rates for AMI were 7.85% and 11.15%, respectively, in 2022, and 10.07% and 11.85%, respectively, in 2023. The corresponding stroke fatality rates were 5.78% (30-day) and 12.60% (1-year) in 2022, and 5.47% (30-day) and 9.28% (1-year) in 2023. The fatality rate for AMI increased subsequently, with the 30-day SFR by AMI rising from 1.30 (95% CI: 0.94–1.67, p=0.0986) in 2022 to 1.61 (95% CI: 1.23–1.99, p=0.0018) in 2023. For other SFR values, no significant elevation in fatality rates was observed relative to native Koreans. Conclusions: Compared to native Koreans, immigrants suffered an increased risk of 30-day mortality after AMI. These findings call for action to understand these disparities and address the barriers to AMI care among immigrants.