Temporal trends and regional disparities in mortality from acute myocardial infarction in Brazil: a time series study, 2015-2024

Objective: To analyze mortality from acute myocardial infarction in Brazil according to temporal trends, sociodemographic characteristics, and regional disparities from 2015 to 2024. Methods: A time series study using annual aggregated data from the Mortality Information System (Sistema de Informações sobre Mortalidade, SIM). Unadjusted mortality rates, age-standardized mortality rates, and sex-specific rate ratios were calculated. Temporal trends were assessed using log-linear regression to estimate the annual percent change (APC), and reestimated using the Prais-Winsten method as a complementary analysis. Results: A total of 938,997 deaths were recorded during the study period. The absolute number of deaths remained stable, with a 3.8% increase between 2015 and 2024. Age-standardized mortality rates declined throughout the study period (annual percent change: −2.6%; p-value<0.001). Mortality was higher among males, with a mean rate ratio of 1.53 over the study period, reaching 1.58 in 2024, and was concentrated among older adults. The Southeast and Northeast regions had the highest unadjusted mortality rates. Conclusion: Age-standardized mortality rates declined over the study period, although the high burden of deaths associated with population aging and regional disparities persisted. These findings reinforce the need to strengthen cardiovascular disease prevention strategies, timely diagnosis, and the organization of the healthcare network for cardiovascular diseases within the Brazilian Unified Health System (Sistema Único de Saúde, SUS).