Temporal and Geographical Disparities in Amyloid and Heart Failure-Related Mortality: An Epidemiological Study 1999-2020.

IF 2.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Hoang Nhat Pham, Ramzi Ibrahim, Thi Nguyen, Enkhtsogt Sainbayar, Mahek Shahid, João Paulo Ferreira, Amitoj Singh, Kwan Lee, W H Wilson Tang, Preethi William
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引用次数: 0

Abstract

Introduction: Amyloidosis complicated by heart failure (HF) poses significant mortality. We sought to identify trends in comorbid amyloidosis and HF mortality in the recent 22- year period.

Methods: Mortality due to amyloid and HF as contributors of death were queried from death certificates using the CDC database from 1999 to 2020. Mortality rates and their 95% confidence intervals were adjusted for age (AAMR) through the Direct method and compared by demographic subpopulations. The Monte-Carlo permutation test was used to estimate the annual percentage change (APC). Log-linear regression models were utilized to assess temporal variation in mortality.

Results: Age-adjusted mortality rates (AAMR) increased from 0.09 [0.08-0.10] in 1999 to 0.27 [0.25-0.29] in 2020. Mortality increased from 1999 to 2013 (APC +1.4, p=0.048) with an accelerating inflection point in 2013 to 2020 (APC +13.3, p<0.001). AAMR was higher among male populations (AAMR 0.20 [0.20-0.21]) compared to female populations (AAMR 0.07 [0.07- 0.07]). A significant inflection point in uprising mortality rates was observed for both male and female populations in 2013 (p<0.001). Mortality was highest among Black populations (AAMR 0.33), followed by White (AAMR 0.10), Asian/Pacific Islander (AAMR 0.06), and American Indian/Alaska Native populations (AAMR 0.04). Among Black populations, mortality remained consistent from 1999 to 2012 (APC +1.1, p=0.184), followed by an increase from 2012 to 2020 (APC +14.0, p<0.001). Among White populations, mortality remained stagnant from 1999 to 2013 (APC +0.7, p=0.302), followed by an increase starting in 2013 to 2020 (APC +13.5, p<0.001).

Discussion: Our findings of a marked rise in HF-related mortality in patients with amyloidosis since 2013 highlighted the profound impact of enhanced diagnostic awareness, novel imaging techniques, and emerging therapeutics. Our analysis also showed mortality disparities between sexes, and geographic locations, races, and ethnicity that warrant targeted public health interventions.

Conclusions: Amyloid and HF mortality increased in the recent 22-year period, primarily starting in 2013, emphasizing the urgent need for targeted intervention to address these disparities.

淀粉样蛋白和心力衰竭相关死亡率的时间和地理差异:1999-2020年的流行病学研究
淀粉样变性合并心力衰竭(HF)造成显著的死亡率。我们试图确定最近22年期间合并淀粉样变性和HF死亡率的趋势。方法:使用CDC数据库,从1999 - 2020年的死亡证明中查询淀粉样蛋白死亡率和HF死亡率。通过直接法调整死亡率及其95%置信区间(AAMR),并按人口统计学亚人群进行比较。采用蒙特卡罗排列检验估计年百分比变化(APC)。采用对数线性回归模型评估死亡率的时间变化。结果:年龄调整死亡率(AAMR)由1999年的0.09[0.08-0.10]上升至2020年的0.27[0.25-0.29]。死亡率从1999年到2013年上升(APC +1.4, p=0.048),并在2013年到2020年加速拐点(APC +13.3, p)。我们的研究结果显示,自2013年以来,淀粉样变性患者的hf相关死亡率显著上升,这突出了增强的诊断意识、新型成像技术和新兴治疗方法的深远影响。我们的分析还显示了性别、地理位置、种族和民族之间的死亡率差异,这需要有针对性的公共卫生干预措施。结论:淀粉样蛋白和心力衰竭死亡率在最近22年期间增加,主要从2013年开始,强调迫切需要有针对性的干预来解决这些差异。
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来源期刊
Current Cardiology Reviews
Current Cardiology Reviews CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
3.70
自引率
10.50%
发文量
117
期刊介绍: Current Cardiology Reviews publishes frontier reviews of high quality on all the latest advances on the practical and clinical approach to the diagnosis and treatment of cardiovascular disease. All relevant areas are covered by the journal including arrhythmia, congestive heart failure, cardiomyopathy, congenital heart disease, drugs, methodology, pacing, and preventive cardiology. The journal is essential reading for all researchers and clinicians in cardiology.
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