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

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.