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Mortality in Women with Coronary Artery Disease in Paraná State, Brazil: A Bayesian Spatiotemporal Analysis

Marcelo Puzzi1, Miyoko Massago1,2, Júlia Loverde Gabella2,3

  • 1Post-Graduation Program in Health Sciences, State University of Maringá, Maringá, Brazil.

Global Heart
|February 5, 2024
PubMed

Insights

Coronary artery disease (CAD) mortality in women aged 50-79 in Paraná, Brazil, decreased by 22.6% from 2010-2019. Improved access to care and municipal performance reduced risks, though regional disparities persist.

Area of Science:

  • Cardiovascular epidemiology
  • Public health research
  • Health services research

Background:

  • Coronary artery disease (CAD) mortality in women is complex, influenced by biological, sociocultural, economic, and healthcare factors.
  • Understanding these determinants is vital for improving healthcare for women.
  • This study focuses on identifying social and clinical variables linked to CAD mortality risk in women aged 50-79 in Paraná, Brazil (2010-2019).

Purpose of the Study:

  • To identify social and clinical variables associated with coronary artery disease (CAD) mortality risk in women aged 50-79.
  • To analyze trends in CAD mortality in Paraná state, Brazil, between 2010 and 2019.
  • To inform targeted public health interventions for reducing CAD mortality in women.

Main Methods:

  • Ecological study utilizing secondary data from E-Gestor, IPARDES, and DATASUS.
  • Bayesian spatiotemporal analysis with Markov Chain Monte Carlo simulations.
  • Integration of raw and standardized CAD mortality rates with sociodemographic and healthcare service variables.

Main Results:

  • A total of 14,603 deaths from CAD were recorded between 2010 and 2019.
  • Overall CAD mortality risk in women decreased by approximately 22.6% from 2010 to 2019, with a notable decline after 2014.
  • Factors contributing to this reduction include increased exercise stress testing (4%), improved cardiology center accessibility (8%), and higher municipal performance index (34%).
  • However, certain regions exhibited higher-than-expected CAD mortality risks, indicating persistent disparities.

Conclusions:

  • CAD-related deaths among women in Paraná state have declined over the past decade.
  • This decrease is linked to enhanced exercise stress testing, better access to cardiology services, and improved municipal performance.
  • Persistent regional disparities necessitate prioritizing strategies to improve cardiovascular healthcare access in less developed areas.
Abstract

Keywords:
coronary artery diseaseepidemiologyhealth disparitiesspatiotemporal analysiswomen’s health

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