Rising burden of coronary artery disease-related mortality among USA adults with atrial fibrillation from 1999 to 2020.

IF 2 4区医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

Coronary artery disease Pub Date : 2025-06-10 DOI:10.1097/MCA.0000000000001540

Muhammad Saad, Ifrah Ansari, Muhammad Umer Sohail, Syed Ibad Ahsan, Saad Ahmed Waqas, Muhammad Sameer Arshad

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引用次数: 0

Abstract

Background: Coronary artery disease (CAD) and atrial fibrillation (AF) are significant cardiovascular conditions with substantial health and economic burdens. Despite advancements in treatment, long-term mortality trends among individuals with both conditions remain underexplored. This study investigates age-adjusted mortality rates (AAMRs) from 1999 to 2020 and examines trends to address these gaps and highlight demographic and geographic disparities.

Methods: Mortality data from the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research database were analyzed for cases where CAD (ICD-10 codes I20-I25) and AF (ICD-10 code I48) were either contributing or underlying causes of death. Individuals aged 25 years and older were included in the analysis. AAMRs were calculated using direct standardization to the 2000 USA population, and trends were assessed using Joinpoint regression analysis. Mortality trends were stratified by sex, race, geography, and urbanization to identify disparities.

Results: Between 1999 and 2020, AAMRs for CAD- and AF-related mortality increased from 14.4 to 23.4 per 100 000, with an average annual percent change of +2.2% (95% confidence interval: 2.0-2.4). Men consistently exhibited higher overall AAMRs than women (22.9 vs. 13.1 ). Non-Hispanic (NH) White individuals had the highest AAMR (18.6), followed by NH American Indians (12.3), NH Blacks (10.0), Hispanics (9.4), and NH Asians (8.0). Rural areas experienced significantly higher AAMRs than urban areas (19.2 vs. 16.6). AAMRs were disproportionately higher in Western (17.7) and Midwestern USA regions (17.7). States in the top 90th percentile reported nearly double the AAMRs compared to those in the bottom 10th percentile.

Conclusion: Mortality rates associated with coexisting CAD and AF have significantly increased, with the most pronounced rise occurring after 2018. The findings reveal substantial disparities across sex, race, and geography. Targeted interventions are essential to address these inequalities, improve health outcomes, and reduce the growing burden of CAD and AF-related mortality.

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1999年至2020年美国成人房颤患者冠心病相关死亡率负担上升

背景：冠状动脉疾病（CAD）和心房颤动（AF）是具有重大健康和经济负担的重要心血管疾病。尽管治疗取得了进步，但这两种疾病患者的长期死亡率趋势仍未得到充分探讨。本研究调查了1999年至2020年的年龄调整死亡率（AAMRs），并探讨了解决这些差距的趋势，并强调了人口和地理差异。方法：从疾病控制和预防中心广泛的流行病学研究在线数据数据库中分析CAD （ICD-10代码I20-I25）和AF （ICD-10代码I48）是导致死亡或潜在死亡原因的病例。年龄在25岁及以上的个体被纳入分析。使用直接标准化方法计算2000年美国人口的aamr，并使用Joinpoint回归分析评估趋势。死亡率趋势按性别、种族、地理和城市化程度分层，以确定差异。结果：1999年至2020年间，冠心病和心房颤动相关死亡率的aamr从14.4 / 10万增加到23.4 / 10万，平均每年变化2.2%（95%置信区间：2.0-2.4）。男性的总体aamr始终高于女性（22.9比13.1）。非西班牙裔（NH）白人的AAMR最高（18.6），其次是NH美洲印第安人（12.3）、NH黑人（10.0）、西班牙裔（9.4）和NH亚洲人（8.0）。农村地区的aamr明显高于城市地区（19.2比16.6）。美国西部地区（17.7）和中西部地区（17.7）的aamr不成比例地高。排名前90百分位的州报告的aamr几乎是排名后10百分位的州的两倍。结论：合并冠心病和房颤的死亡率显著上升，2018年之后的上升最为明显。研究结果揭示了性别、种族和地域之间的巨大差异。有针对性的干预措施对于解决这些不平等、改善健康结果和减少冠心病和心房颤动相关死亡率日益增加的负担至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Coronary artery disease 医学-外周血管病

CiteScore

2.50

自引率

0.00%

发文量

190

审稿时长

6-12 weeks

期刊介绍： Coronary Artery Disease welcomes reports of original research with a clinical emphasis, including observational studies, clinical trials, translational research, novel imaging, pharmacology and interventional approaches as well as advances in laboratory research that contribute to the understanding of coronary artery disease. Each issue of Coronary Artery Disease is divided into four areas of focus: Original Research articles, Review in Depth articles by leading experts in the field, Editorials and Images in Coronary Artery Disease. The Editorials will comment on selected original research published in each issue of Coronary Artery Disease, as well as highlight controversies in coronary artery disease understanding and management. Submitted artcles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and peer-review by the editors and those invited to do so from a reviewer pool.