Changing trends in myocardial infarction mortality among young adults in the United States: a 25-year analysis of disparities and the COVID-19 impact.

Abstract

Introduction: Myocardial infarction (MI) generally occurs among old individuals. However, changing dietary patterns, stress, and smoking have led to an increased risk of MI among young adults. This study aimed to analyze 25-year MI-mortality-related trends among young adults (15-44 years) in the US.

Material and methods: The death certificates from the CDC WONDER database (1999-2023) were analyzed to identify MI-related mortality, reporting age-adjusted mortality rates (AAMRs) per 100,000 people, and annual percentage changes (APCs).

Results: A total of 91,482 deaths were attributed to MI among young adults in the US from 1999 to 2023. The AAMRs declined from 3.8 in 1999 to 2.5 in 2018, followed by an increase to 3.2 by 2021 (APC = 8.1), coinciding with the COVID-19 pandemic. This was followed by a decline to an AAMR of 2.3 in 2023. Men had consistently higher AAMR compared to women throughout the study period (average AAMR: 4.5 vs. 1.8). Among racial/ethnic groups, the highest AAMR was observed in the non-Hispanic (NH) Black or African American individuals (5), followed by the NH White (3.2), Hispanic or Latino (1.5), and NH Other populations (1.3) in 2023. The southern region had the highest AAMR when stratified by census regions, and rural areas had higher mortality rates than urban areas (6.4 vs. 2.6).

Conclusions: From 1999 to 2023, MI-related mortality among young adults in the US showed an overall decline, with a temporary increase during the COVID-19 pandemic. Men, NH Black individuals, and those in rural or southern regions had consistently higher mortality rates. These findings highlight persistent disparities in MI-related mortality across demographic and geographic groups.