Abstract Body: Introduction
Ischemic heart disease (IHD) remains a leading cause of death globally, with its impact disproportionately higher in underserved regions, where access to specialist care is limited. In rural areas like Portage County, Ohio, geographic isolation and lack of local healthcare options have led to delayed treatment and poor outcomes. In 2016, a local catheterization (cath) lab, alongside comprehensive cardiovascular screening and prevention programs, was established to address the issue.

Hypothesis
We assessed the hypothesis that the introduction of local specialist cardiovascular services would be associated with a reduction in crude death rates (CDRs) from IHD in Portage.

Methods
This retrospective study analyzed CDRs for IHD (reported per 100,000) from the CDC WONDER database (Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research) from 2000 to 2019, stratified by age group. Hospital records provided data on angiograms performed from 2016 to 2022. We utilized linear regression and interrupted time series analysis to evaluate correlation between the intervention and CDR trends. As the study used publicly available secondary data and anonymized hospital records, no ethics approval was required.

Results
From 2016 to 2019, over 3000 catheterizations were performed. During this period, a general decline in CDRs was observed across all age groups, especially in the older groups: in the 65-74 age group, rates dropped by 36% (294.2 in 2015 to 188.1 in 2019), while the 75-84 and 85+ age groups saw declines of 21% (817.1 to 648.6) and 28% (3715.6 to 2657.8), respectively. However, statistical significance (p>0.05) was not reached due to limited post-intervention dataset.

Conclusion
Early findings suggest that increasing access to specialist cardiovascular services may be associated with reduced IHD mortality in underserved regions like Portage. However, other factors like healthcare improvements, may have also influenced the results, and further analysis with a longer post-intervention period and comparison with control regions are needed to confirm these trends. These early results nonetheless offer insights into the potential of such specialist services to improve health outcomes in rural and underserved regions.