Admissões e óbitos por insuficiência cardíaca e infarto agudo do miocárdio no estado de Minas Gerais análises de séries temporais

Abstract

Cardiovascular diseases (CVD) remain among the leading causes of morbidity and mortality worldwide and in Brazil, with acute myocardial infarction (AMI) and heart failure (HF) standing out as major contributors. These conditions are closely linked in both their pathophysiological mechanisms and risk factors. In this context, the present study aimed to conduct a comprehensive temporal analysis of hospital admissions and deaths due to AMI and HF in adults over 20 years of age in the state of Minas Gerais, Brazil, from 2016 to 2022, considering sex differences and associated comorbidities. Data were obtained from the Hospital Information System of the Brazilian Unified Health System (SIH-SUS), encompassing all hospital admissions recorded in the state. To examine temporal trends and fluctuations, autoregressive moving average models with exogenous covariates (ARMAX) were applied, including the evaluation of seasonal components and potential interventions related to external events, such as the COVID-19 pandemic. A total of 90,670 hospitalizations due to AMI were recorded, with a mean lethality rate of 8.5%, and 178,477 hospitalizations due to HF, with a lethality rate of 10%. AMI was more prevalent among men, whereas HF predominated in women, suggesting distinct patterns of vulnerability between sexes. Winter periods were significantly associated with increased hospitalizations for both conditions, indicating a possible influence of environmental and seasonal infectious factors. Additionally, hospitalizations for respiratory diseases showed a positive correlation with the risk of cardiovascular events, reinforcing the role of systemic inflammation and acute respiratory infections as triggers for cardiac decompensation. During the COVID-19 pandemic, a marked reduction in CVD hospitalizations was observed, likely due to mobility restrictions, patients’ fear of seeking hospital care, and the reorganization of healthcare services. However, in September 2020, there was a significant increase in male deaths from AMI, suggesting a delayed cardiovascular impact of the pandemic. Another noteworthy finding was the inverse relationship between AIDS-related hospitalizations and HF deaths in women, possibly reflecting differences in clinical follow-up and the cardioprotective effects of antiretroviral therapy. Trend analyses revealed divergent patterns between the two diseases: while HF hospitalizations showed a downward trend, AMI hospitalizations tended to increase over time, reflecting potential changes in the epidemiological profile and the effectiveness of preventive and therapeutic strategies. In summary, this study highlights that seasonal and infectious factors exert a significant influence on the behavior of cardiovascular diseases, and that the pandemic period introduced transient alterations in hospitalization and mortality curves. These findings reinforce the importance of continuous epidemiological surveillance and the strengthening of public health policies aimed at prevention, early diagnosis, and effective management of CVD, with particular attention to sex differences and associated comorbidities