Different patterns of association between education and wealth with non-fatal myocardial infarction in Tehran, Iran: A population- based case-control study

Background: Myocardial Infarction (MI) is a main cause of death and disability worldwide, whichinvolves a number of genetic, physiopathologic and socio-economic determinants. The aim of thisstudy was to assess the patterns of association between education, wealth and some other risk factorswith non-fatal MI in Tehran population.Methods: Data derived from a second round of large cross-sectional study, Urban HEART-2, conductedin Tehran in 2011. Out of 118542 participants, all 249 self-reported incident cases of nonfatalMI were selected as the case group. A number of 996, matched on age and sex, were selected ascontrols. Principle component analysis (PCA) was used to calculate wealth index and logistic regressionmodel to assess relations between the study variables.Results: Mean (SD) age of participants was 60.25 (12.26) years. A total of 870 (69.9%) of thestudy subjects were men. Education, wealth status, family violence, hypertension and diabetes wereobserved as independent predictors of non-fatal MI. Overall, as the level of education increased, theodds of non-fatal MI decreased (p<0.001). We observed an almost J-shaped association betweenwealth status and non-fatal MI. No significant associations were found between marital status, BMIand current smoking with non-fatal MI (p<0.05).Conclusion: We found different patterns of association between education and wealth with nonfatalMI among Tehran adults. Lower risk of non-fatal MI is linked to high educated groups whereas economicallymoderate group has the lowest risk of non-fatal MI occurrence