Temporal trends in acute coronary syndrome among women and association with socioeconomic factors—evidence from a middle-income country

Introduction Since Acute Coronary Syndrome (ACS) death rates remain a challenge underscoring the importance of socioeconomic factors, the aim of the study was to explore the trend in incidence, mortality, and mortality-to-incidence ratio (MIR) of ACS and Myocardial Infarction (MI) among women in Serbia, middle income country, from 2006 to 2022, as well possible association with the Human Development Index (HDI), Social Demographic Index (SDI), and Years of Life Lost (YLL). Methodology The research was conducted according to the principles of a descriptive epidemiological study, using data extracted from publicly accessible yearbooks, registry and reports (count, and age-standardized rates). Statistical analysis was performed using Joinpoint Regression analysis with the Joinpoint Regression Program version 5.4. Results and discussion There were a significant declining trend of MI incidence (APC −2.1, p = 0.005) and mortality rates (APC −7.8, p < 0.001); ACS incidence did not change significantly, while ACS mortality decreased (APC −6.8, p < 0.05). There was significant association between trend of ACS and MI incidence, mortality and MIR at women in Serbia, and increasing trend of HDI and SDI. The constant decline in YLL followed, but the number of lost years remains high (APC −5.9, p < 0.001). Conclusion Consistently high mortality rates from ACS and MI among women in Serbia may be attributed to the complex phases of socioeconomic transformation the country has experienced, characterised by high exposure to risk factors and insufficient health promotion and prevention strategies. Urgently prioritising cost-effective, multidisciplinary prevention strategies for women, adapted to local contexts and aligned with health and other Sustainable Development Goals, is critical to reducing global disparities in cardiovascular outcomes.