Introduction Myocardial re-infarction is common and carries a high mortality rate. The risk of myocardial re-infarction in Sweden is less known, and no studies are conducted to consider re-infarction among immigrants in Sweden. We are aimed to compare the risk of myocardial re-infarction among foreign-born to the risk among those born in Sweden.

Methods We followed a cohort of 330 thousand men and more than 180 thousand of women ages 30 to 85 years between 1987and 2008 through linkages between Swedish National Registers. HR is adjusted for age, calendar year of diagnosis of first MI and education. The main outcome measure was second myocardial infarction in relation to main exposure which is country of birth.

Results We observed an overall higher risk of second MI among immigrants compared to swedes, the risk was statistically significantly 5% higher (HR 1.05; 95% CI 1.02 to 1.09) among women foreign-born and 7% higher (HR 1.07; 95% CI 1.04 to 1.10) among men foreign-born.The risk decrease with increasing level of education for both Swedes and immigrants and with increasing age the risk will increase.

Conclusion The higher risk of second myocardial infarction among immigrant in Sweden apart from common risk factors (life style, stressful migration, problem in communication) also might be due to differences in access and utilisation of care after MI. It is important for healthcare providers to guarantee the equality of healthcare and to be directed by medical requirements.