Abstract Details

Title Proportion of Life in Canada and Stroke Incidence and Outcomes in Immigrants

Topic Health Care Disparities

Presentation(s) P1 - Poster Session 1 (9:00 AM-5:00 PM)

Poster/Presentation
Number 212

Objective

To evaluate the association between acculturation assessed using proportion of life in Canada and stroke incidence and outcomes in immigrants.

Background Canadian immigrants have been shown to have lower risk of stroke incidence and stroke fatality compared to host populations, but it is unclear if this risk changes with acculturation.

Design/Methods We followed immigrants to Ontario, Canada after 1985, without a history of stroke from 2003 to 2018 to determine incidence of ischemic stroke (primary outcome), defined as emergency visit or hospitalization. We created another cohort of immigrants admitted with an ischemic stroke between 2003 and 2012 and followed them until 2018 to ascertain all-cause mortality (secondary outcome). We modelled the proportion of life spent in Canada (p), derived from time since immigration and age at immigration, using restricted cubic splines. To evaluate the association between proportion of life spent in Canada and outcomes of interest, we used cause-specific hazard models with age as the time scale (and thereby adjusting for age), adjusting for sex and comorbidities.

Results

Of the included 1.2 million immigrants, 11,604 (1.0%) had an ischemic stroke over a median follow-up of 15-years. Compared to the median value of p=0.2, a J-shaped association between proportion of life spent in Canada and the risk of ischemic stroke was noted, with lower hazard in those with p<0.2 (HR_p_=0.05 1.15; 1.09-1.21) and a progressive increase in stroke risk with a greater proportion of life spent in Canada in those with p>0.2 (HR_p_=0.50 1.45; 1.27-1.66). In the second cohort of 2712 immigrants with ischemic stroke, a similar, but a non-significant, J-shaped association was noted between proportion of life in Canada and post-stroke mortality.

Conclusions The rate of stroke in Canadian immigrants tended to increase with increasing proportion of life spent in Canada. Our findings support acculturation and require further studies to understand it.

Authors/Disclosures
Manav Vyas, MD (MV VYAS MEDICINE PROFESSIONAL CORPORATION) PRESENTER	The institution of Dr. Vyas has received research support from Heart and Stroke Foundation of Canada . The institution of Dr. Vyas has received research support from Canadian Institutes of Health Research . Dr. Vyas has received research support from Heart and Stroke Foundation of Canada .
	No disclosure on file
	No disclosure on file
Moira Kapral, MD (Toronto General Hospital)	The institution of Moira Kapral, MD has received research support from Heart and Stroke Foundation of Canada, Canadian Institutes of Health Research.

��ɫ��

��ɫ��