Unraveling trends and disparities in acute myocardial infarction-related mortality among adult cancer patients: A nationwide CDC-WONDER analysis (1999–2020)

IF 1.9 Q3 PERIPHERAL VASCULAR DISEASE

International Journal of Cardiology Cardiovascular Risk and Prevention Pub Date : 2025-01-22 DOI:10.1016/j.ijcrp.2025.200371

Humza Saeed , Uzair Majeed , Minahil Iqbal , Sufyan Shahid , Anum Touseef Hussain , Hammad Ahmad Iftikhar , Momina Riaz Siddiqui , Iftikhar Ali Ch , Salman Khalid , Naeem Khan Tahirkheli

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Abstract

Background

Cancer patients are at an increased risk for the incidence and complications of acute myocardial infarction (AMI) due to shared risk factors and treatment-related adverse effects. Mortality trends for AMI-related deaths in adult cancer patients in the U.S. remain unexplored.

Methodology

This study used CDC WONDER data for death certificates from 1999 to 2020, identifying U.S. adults (≥25 years) with cancer (ICD-10: C00-D49) who died of AMI (ICD-10: I21) as the underlying cause. Age-adjusted mortality rates (AAMRs) and annual percent changes (APCs) were calculated and stratified by gender, age, race, and geographic location.

Results

Between 1999 and 2020, there were 109,462 AMI-related deaths in adult cancer patients. The AAMR decreased from 4.3 per 100,000 in 1999 to 1.4 in 2020. A significant decline occurred from 1999 to 2015 (APC: 6.65; 95 % CI: 6.95 to −6.40; p < 0.001), followed by a stable trend from 2015 to 2020 (APC: 1.36; 95 % CI: 2.69 to 0.91; p = 0.152). Men had higher AAMRs than women (3.5 vs. 1.5). AAMRs were highest in older adults (10.5) compared to middle-aged (0.7) and young adults (0.1). Racial disparities showed the highest AAMRs in non-Hispanic (NH) Black patients (2.7), followed by NH Whites (2.4), NH American Indian/Alaska Native (1.6), Hispanic/Latino (1.3), and NH Asian/Pacific Islander (1.1). Non-metropolitan areas had higher AAMRs than metropolitan areas (2.8 vs. 2.2).

Conclusions

This analysis highlights a significant decline in AMI-related mortality among cancer patients in the U.S., with persistent disparities by gender, age, race and geographical location.

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成人癌症患者急性心肌梗死相关死亡率的趋势和差异：一项全国性的CDC-WONDER分析（1999-2020）

背景：由于共同的危险因素和治疗相关的不良反应，癌症患者急性心肌梗死（AMI）的发生率和并发症的风险增加。美国成人癌症患者ami相关死亡的死亡率趋势仍未研究。方法：本研究使用1999年至2020年CDC WONDER死亡证明数据，确定美国成年人（≥25岁）癌症（ICD-10: C00-D49）死于AMI （ICD-10: I21）是潜在原因。计算年龄调整死亡率（AAMRs）和年变化百分比（APCs），并按性别、年龄、种族和地理位置分层。结果1999年至2020年间，成人癌症患者中有109,462例ami相关死亡。AAMR从1999年的4.3 / 10万下降到2020年的1.4 / 10万。1999 - 2015年显著下降(APC: 6.65；95% CI: 6.95 ~ - 6.40；p & lt;0.001)，其次是2015 - 2020年的稳定趋势(APC: 1.36；95% CI: 2.69 ~ 0.91；p = 0.152)。男性的aamr高于女性（3.5比1.5）。与中年人（0.7）和年轻人（0.1）相比，老年人（10.5）的aamr最高。种族差异显示，非西班牙裔黑人患者的aamr最高（2.7），其次是NH白人（2.4），NH美洲印第安人/阿拉斯加原住民（1.6），西班牙裔/拉丁裔（1.3）和NH亚洲/太平洋岛民（1.1）。非都市地区的aamr高于都市地区（2.8比2.2）。结论：该分析强调了美国癌症患者ami相关死亡率的显著下降，但存在性别、年龄、种族和地理位置的持续差异。

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