## 2 Acute Myocardial Infarction
### Predisposition to the Development of CVDs in LATAM  
In recent years, socioeconomic status, education level, and ethnic origin have been demonstrated as the independent predictors of an increased risk of CVD-related death. Furthermore, risk factors such as smoking, age, blood pressure, sex, and cholesterol remain important predictors [39]. For example, an association between education and the development of certain diseases has been observed. In this sense, a study found that in Eastern European countries, women aged 15-44 years with a lower education level showed a 2.3 times higher risk of AMI than those with a higher education level. However, among non-European women, the risk of AMI was 33% higher in those with a higher education level. This suggests that a low education level is associated with an increased risk of AMI in Eastern Europe but not in the other three regions. Thus, factors are differentially involved in the interplay of population-specific characteristics affecting educational differences in the risk of AMI and stroke [40]. In another study, individuals in high-income countries that have large seasonal oscillations in temperature could be influenced by cold weather and develop CVDs. In these countries, winter can produce biological mechanisms, such as higher sympathetic nervous system activation, uncontrolled hypertension, and an increased incidence of respiratory diseases. Other conditions such as shorter days, reduced physical activity, depression, and higher pollution levels were involved. Moreover, in low- and middle-income regions with tropical and subtropical climates (Brazil), the numbers of heart failure and AMI hospitalizations also increase in winter. This is not related to the temperature oscillations. However, other factors, such as precarious housing conditions, lack of thermal insulation, and greater pollution might increase the seasonal effect of winter on risk [41]. Regarding ethnicity, some authors reported marked racial and ethnic disparities with respect to access to a diagnosis and adequate treatment of valvular heart disease. In addition to the scarcity of research on the causes of heart disease, some authors reported that, during patient recruitment for determining the in-depth causes of AF, most observational studies and clinical trials have included predominantly white populations with an under  
Figure 1: Acute myocardial infarction and other ischemic heart disease mortality change from 2000–2019 (Taken and modified from: Health at a Glance 2019– © OECD 2019) [35]. representation of minorities' racial and ethnic differences, highlighting the need for an inclusive participation in research [42]. Thus, CVDs show an increased prevalence in LATAM countries (specifically Mexico), given that LATAM probably has the greatest economic disparities that cause high poverty, malnutrition, disease, and limited opportunities [43]. Unique features have allowed the development of health problems specific to this region [40]. Regardless, health infrastructure and research are lacking. On the other hand, additional AMI-associated factors have demonstrated an upward trend due to the particular characteristics of LATAM populations. For example, the rate of increase of obesity appears to be slowing in most high-income countries; however, it continues to rise in many low- and middle-income countries [44]. The possible causes for this vary, but some authors cited that the prevalence of excess weight and obesity has increased since the signing of the North American Free Trade Agreement in Mexico. This was caused by the new economic model that allowed rural populations to move from rural to urban centers, resulting in a food transition [45]. This transition increased food security, augmented the availability of cheap sources of vegetable oils, resulted in more meals away from home, decreased the arduous nature of working, and increased passive recreation (especially television).