About the PhD thesis

The number of immigrants has increased in Denmark as well as in Europe during the last decades and is projected to increase further due to conflicts, climate changes, and economic factors. This results in a heterogeneous and multicultural patient population. Furthermore, it is known that there is inequality regarding both general health and cardiovascular diseases between immigrants and the host population.

Atrial Fibrillation (AF) is the most common sustained arrhythmia in Western countries. AF has a current prevalence of approximately 2% which is estimated to double by the year 2050. The prevalence may, however, be much higher as many cases of AF remain undiagnosed. AF is associated with increased risks of death, stroke, major bleeding, and heart failure. According to European guidelines, AF-patients with a high risk of stroke should be treated with oral anticoagulation therapy. There seems to be a paucity of data on AF and immigrants.

The aim of this thesis was to examine if there are differences in incidence rates of first-time hospital diagnosis of AF, clinical outcomes after an AF diagnosis, and initiation of OAC if the patient is at high risk of stroke when comparing immigrants with individuals of Danish origin.

This thesis underlines that some immigrant groups appear to be worse off than the Danish host population in relation to several aspects of AF. Possible underlying mechanisms to this can be macro structural factors such as the design of the healthcare system and health and migrant policy, furthermore, it can be predisposing factors such as reason for migration and discrimination. Resources such as health literacy and a social network are also elementary in accessing relevant health care.