Myocardial Infarction Iincidence at the Northwest of Iran 2014–2018: A Spatial Analysis

Background: Myocardial Infarction (MI) is a major important public health concern and has huge burden on health system across the world. This study aimed to explore the spatial variation of MI incidence and investigate if there is a spatial clusters in the MI patterns among rural areas in Zanjan province, Iran.Materials & MethodsThis was a retrospective and geospatial analysis study using MI incidence data from 2014-2018 from nine hospital information system databases. Three different spatial analysis methods (Spatial autocorrelation, hotspot analysis and cluster and outlier analysis) were used to identify potential clusters and high-risk areas of MI incidence at the study area.Results3,820 patients were registered at Zanjan hospitals due to MI during 2014-2018. The age-adjusted incidence rate of MI was 343 cases per 100,000 person which raised from 88 cases in 2014 to 114 cases in 2018 per 100,000 person (a 30% increase, P<0.001). Golabar region had the highest incidence rate of MI (515 cases per 100,000 person). Five hotspot and one high-high cluster were detected using spatial analysis methods.ConclusionThis showed that there is a great deal of spatial variations in the pattern of MI incidence in Zanjan province. The high incidence rate of MI in the study area compared to the national average, is a warning to local health authorities to determine the possible causes of disease incidence and potential drivers of high-risk areas. The spatial cluster analysis provided new evidence for policy-makers to design tailored interventions to reduce MI incidence and allocate health resource to unmet need areas.