The Geography of Acute Cardiac Care: Toward Elimination of Cardiology Deserts in New Mexico.

摘要

Cardiovascular disease remains the leading cause of mortality in New Mexico, where access to timely acute cardiac care is substantially influenced by geography. Large portions of the state are characterized by vast distances, limited specialty infrastructure, and a predominantly rural and frontier population, exposing the limitations of population-density-based models of regionalized cardiovascular care. Drawing on clinical experience across both tertiary referral centers and rural hospitals and informed by publicly available state-level mortality and health infrastructure data, this Perspective examines "cardiology deserts" as a manifestation of system-level inequities in time-critical cardiac care delivery. The geographic clustering of 24/7 percutaneous coronary intervention-capable centers along major population corridors, particularly the I-25 axis, leaves extensive regions of the state reliant on prolonged interfacility transfer or delayed reperfusion strategies. Statewide cardiovascular mortality patterns parallel these spatial distributions, suggesting that geographic distance-independent of individual patient characteristics-functions as a clinically meaningful barrier to timely reperfusion, disproportionately affecting rural, frontier, Hispanic, and Native American communities. Addressing cardiology deserts in New Mexico requires a reframing of regionalized cardiac care that explicitly recognizes geography as a determinant of time-sensitive cardiovascular outcomes. Potential strategies include strengthening pharmaco-invasive reperfusion pathways, expanding telecardiology support for rural clinicians, and redesigning transfer networks to better reflect the realities of low-density practice environments. Without deliberate system-level adaptation, geographic distance will remain an underrecognized contributor to avoidable cardiovascular mortality in geographically expansive regions. In conclusion, aligning regional cardiac care models with geographic realities will be essential to reducing avoidable cardiovascular mortality in rural and frontier regions.