Ischaemic heart diseases and stroke are among the leading causes of death in Latin America (see Chapter 3). These diseases impose substantial health, economic and social costs, both through premature mortality and long-term disability among survivors. Over recent decades, outcomes following acute myocardial infarction (AMI) and stroke have improved in many countries, supported by advances in medical technologies and treatment protocols, including lipid- and blood-pressure‑lowering therapies, thrombolysis and angioplasty (OECD, 2015[1]). Thirty-day in-hospital case fatality rates for AMI and stroke are widely used indicators of the quality of acute care. These measures reflect the effectiveness and timeliness of emergency responses and hospital treatment pathways, including rapid diagnosis, access to reperfusion therapies, and co‑ordinated patient transport. At the same time, case fatality rates may also be influenced by patient characteristics, such as case severity, as well as differences in admission practices.
For AMI, age‑ and sex-standardised 30‑day in-hospital mortality rates in Paraguay (24.2%), Mexico (22.6%) and Peru (19.9%) are substantially higher than the OECD average mortality (6.5%). Ecuador (10.9%) and Chile (8.8%) report higher mortality than OECD average but within the OECD range, while Costa Rica (6.8%) and Colombia (5.6%) are closer to, or below, the OECD average (Figure 7.9).
There are also important cross-country differences in fatality rates within 30 days after admission for ischemic stroke (Figure 7.10). Peru reports the lowest 30‑day mortality rate (2.5%). Nevertheless, this measure is considerably below findings in published literature, were a 6.9 in-hospital case fatality rate was found in 2017 (Labán-Seminario, Carrillo-Larco and Bernabé-Ortiz, 2022[2]). While other factors such as a high incidence of first-ever strokes in Peruvian general population can also contribute to lower rates (Lazo-Porras et al., 2022[3]), this measure should be interpreted with caution because of quality and comparability of recording and reporting practices. Colombia (6.1%) and Ecuador (7.8%), sit close below the OECD average (8.7%). Chile’s rate (8.8%) is close to the OECD average, while Paraguay (11.8%), Costa Rica (15.3%) and Mexico (17.0%) report markedly higher mortality.
Mortality following haemorrhagic stroke is, as expected, considerably higher than for ischaemic stroke across all countries (Figure 7.11). Mexico (30.6%), Paraguay (25.6%), Costa Rica (25.3%) and Chile (24.7%) all report rates above the OECD average (23.4%). In contrast, Ecuador (17.0%) and Peru (11.4%) show lower fatality rates.
While LAC countries have made progress in reducing the burden of cardiovascular disease, greater emphasis is needed on improving the quality and consistency of acute care. Improving cardiovascular and cerebrovascular outcomes requires a co‑ordinated, people‑centred approach spanning across prevention and early detection, strong and preventive primary care, timely referral to emergency services, and the consistent use of up-to-date, evidence‑based clinical protocols (OECD, 2025[4]). Strengthening health information systems and analytical capacity is essential for routine monitoring and international comparability. Yet only seven LAC countries can currently report comparable quality-of-care indicators for AMI and stroke, and even measures miss important aspects of acute management and post-discharge care (see box below). Moreover, important indicators such as access to thrombolysis, haemodynamic services, and specialised stroke units are essential for accurate performance assessment of acute CVD conditions, but remain limited in the region. Interpretation of the presented indicators also requires caution: observed differences may reflect variation in access to emergency and hospital services and in admission, registration and coding practices. For example, very low case fatality rates in some countries (e.g. Peru) may partly signal access barriers or selective hospital admission rather than better care.
