Excess risk for acute myocardial infarction mortality during the COVID-19 pandemic

Area of Science:

• Cardiovascular Disease Epidemiology
• Public Health Surveillance
• Infectious Disease Impact

Background:

• The COVID-19 pandemic significantly disrupted healthcare systems globally.
• Pre-pandemic trends showed decreasing acute myocardial infarction (AMI) mortality rates across demographics.
• Understanding pandemic-related shifts in AMI mortality is crucial for public health interventions.

Purpose of the Study:

• To assess the extent and disparities in excess AMI-associated mortality during the COVID-19 pandemic, including the Omicron surge.
• To analyze temporal trends in AMI mortality by demographic groups and geographic regions.
• To identify specific age and sex groups disproportionately affected by excess AMI deaths.

Main Methods:

• Utilized the CDC's National Vital Statistics System data for AMI-associated deaths from April 2012 to March 2022.
• Calculated age-standardized mortality rates (ASMR), comparing observed versus predicted rates to determine excess mortality.
• Analyzed trends accounting for seasonality and examined disparities across demographic subgroups and regions.

Main Results:

• AMI-associated mortality rates reversed their pre-pandemic decline during the pandemic.
• Significant increases in AMI mortality were observed in younger females and males, persisting through the Omicron surge.
• Excess deaths were most pronounced in the youngest age groups (25-44 years), with rates 23%-34% higher than predicted.

Conclusions:

• Excess AMI-associated mortality has disproportionately affected younger adults, with notable age and sex disparities.
• These disparities persisted even through the recent Omicron variant surge.
• The findings underscore the need for targeted public health strategies to address cardiovascular risks exacerbated by the pandemic, especially in vulnerable younger populations.