Distribuição Espacial Dos Serviços De Reperfusão Coronariana E Seu Impacto Na Mortalidade Por Infarto Agudo Do Miocárdio No Estado Do Paraná, Brasil

Objective: To analyze the impact of geographic location of coronary reperfusion (CR) services on acute myocardial infarction (AMI) mortality in Parana State, Brazil. Methods: This is a cross-sectional, ecologic study based on AMI mortality, between 2015 and 2019, among individuals aged 30–79 years. An spatial access index to CR services within 60 minutes of ground transportation was calculated using the enhanced two-step floating catchment area technique. AMI mortality rates were compared between municipalities with and without CR services coverage and between municipalities with low and high spatial access to CR services, both using the Wilcoxon test. Results: It was observed that 8.02% (32/399) of municipalities had access to two methods of reperfusion therapy, 24.56% (98/399) had access only to primary percutaneous coronary intervention, and 12.03% (48/399) had access only to chemical reperfusion. Municipalities with access to CR services had lower mortality rate (median = 74.67) than municipalities not covered by this service (median = 102.83) (p

Healthcare during COVID-19 Pandemic · Healthcare Regulation · Medicine · Public Health in Brazil