Background

The burden of cardiovascular diseases is considerably higher in the former German Democratic Republic compared to the average level in the united Germany. To draw a detailed picture of local burden of myocardial infarction and the possible impact of associated regional characteristics, we compared hospitalisation rates of an urban and highly deprived area with rural and less deprived neighbouring regions in eastern Germany. In addition, we compared hospitalisation rates of the period before and during the COVID-19 outbreak in order to detect possible delays in emergency care for AMI.

Methods

We used routinely collected data of all patients with AMI hospitalised in the city of Brandenburg an der Havel between May 2019 and May 2020. Postal codes within the catchment area for AMI of the Hospital Brandenburg were selected to determine hospitalization rates. We used Poisson regression to calculate rate ratios comparing the city of Brandenburg with neighbouring areas, as well as rate ratios comparing the period of the COVID-19 outbreak with the preceding period. Publicly available regional social and healthcare-related characteristics were mapped to contextualise our results.

Results

265 cases of AMI were registered in the study area which comprised 116,126 inhabitants. In the rural and less deprived areas, the age and sex adjusted hospitalisation rate was 29 % lower (p=0.01) compared to the deprived city of Brandenburg. During the outbreak of COVID-19, the age adjusted hospitalisation rate was 22 % higher among women (p=0.46) and 24 % lower among men (p=0.04) compared to the preceding period, with weak evidence for effect measure modification by sex (p=0.10).

Conclusions

We hypothesise that the difference in hospitalisation rates between the city of Brandenburg and adjacent rural areas may be explained by the higher socioeconomic deprivation of the city. Moreover, the impact of the COVID-19 outbreak on emergency care for AMI might be sex-specific in the study area.