Epidemiological aspects, hospitalizations, and mortality due to acute myocardial infarction in Brazil: An integrative review

Abstract

Introduction: Acute Myocardial Infarction (AMI) is a major public health issue in Brazil, associated with high morbidity and mortality and a significant demand for hospital care. Although studies on its epidemiological profile exist, differences in populations, data sources, and indicators used hinder the comparison of results, highlighting the need for a critical synthesis of available evidence. Objective: To critically analyze scientific evidence regarding the epidemiological profile of AMI in Brazil, focusing on hospitalizations, mortality, temporal trends of indicators, and sociodemographic and regional distribution, while identifying convergences, divergences, and methodological limitations among the studies. Methods: This is an integrative literature review of a qualitative and descriptive nature, based on the methodological steps proposed by Whittemore and Knafl. The primary search was conducted on October 2, 2026, in the PubMed/MEDLINE, SciELO, and Virtual Health Library (VHL) databases, using controlled descriptors and free-text terms related to AMI, epidemiology, morbidity and mortality, and Brazil. Studies published in Portuguese, English, and Spanish were considered, with no explicit time limit. Primary observational studies concerning the Brazilian population, with results related to the established epidemiological indicators, were included. A supplementary search on cardiovascular rehabilitation and physical therapy was used exclusively for theoretical contextualization and was not included in the study sample. The synthesis was descriptive and qualitative, without the application of a standardized tool for assessing risk of bias. Results: The primary search identified 130 records: 30 in PubMed/MEDLINE, 40 in SciELO, and 60 in the VHL. Prior to screening, 60 duplicate records and 20 records classified as ineligible document types were removed. Of the 50 screened records, 25 were excluded. Following a full-text review of 25 publications, 20 were excluded, resulting in five primary observational studies. The findings revealed differences in the distribution of hospitalizations and deaths due to acute myocardial infarction (AMI) based on sex, age, region, and the period analyzed. A nationwide study covering 2008–2024 identified 1,910,231 hospital records and 199,947 deaths, describing an increase in the occurrence rate and a decrease in case-fatality rates. Another investigation recorded 675,374 admissions between 2018 and 2022, showing a male predominance (63.67%), a concentration in the Southeast region (49.09%), and a high proportion of emergency admissions (90.84%). Deaths among young adults and a higher concentration of records in older age groups were also identified, alongside a positive ecological association between municipal human development and hospitalizations of the elderly in the Central-West region (r = 0.37; p = 0.011). The heterogeneity of indicators, timeframes, and data sources limited the comparability of the results. Hospital records were not considered equivalent to incident cases in the general population. Conclusion: AMI imposes a significant burden of hospitalization and mortality in Brazil, characterized by sociodemographic, territorial, and temporal variations. However, the limited sample size, methodological heterogeneity, information system coverage limitations, and the absence of a formal risk-of-bias assessment restrict the generalizability of the findings. Studies utilizing standardized indicators, appropriate population denominators, and broader territorial coverage are needed to accurately characterize AMI-related morbidity and mortality in the country. Cardiovascular and physical therapy rehabilitation were addressed solely as supplementary literature, precluding conclusions regarding their effectiveness based on the analyzed sample.