Mortality patterns of coronary artery diseases and atrial fibrillation in adults in the United States from 1999 to 2022: An analysis using CDC WONDER.

Abstract

Background: Coronary artery disease (CAD) and atrial fibrillation (AF) contribute significantly to global mortality and frequently co-exist due to shared risk factors like hypertension and diabetes. This study seeks to explore the relatively overlooked area of mortality patterns among adults who have both coronary artery disease and atrial fibrillation.

Methods: Mortality data for individuals aged ≥25 were obtained from CDC WONDER using ICD-10 codes I20-25 (CAD) and I48 (AF). Age-adjusted mortality rates (AAMR) and crude mortality rates per 100,000 were calculated. Trends were analyzed by gender, year, race, urbanization, and state. JoinPoint regression estimated annual percent change (APC) and average annual percent change (AAPC) with 95 % confidence intervals (CI).

Results: From 1999 to 2022, there were 942,461 recorded deaths among individuals with CAD and AF in the United States. The AAMR rose from 14.35 in 1999 to 24.53 in 2022, resulting in an AAPC of 2.56* (95 % CI, 2.24 - 2.85). The AAMR showed a consistent increase throughout the study period, with a significant spike from 2018 to 2022 (APC: 6.87*; 95 % CI, 4.82 - 10.66). Men consistently had higher AAMRs than women. Non-Hispanic (NH) White individuals reported the highest AAMR, followed by NH Black, Hispanic, and NH other populations. Nonmetropolitan areas exhibited higher AAMR than metropolitan regions.

Conclusions: AAMR showed a moderate rise from 1999-2018, followed by a sharp increase from 2018-2022, possibly linked to COVID-19. Further research is needed to understand contributing factors.