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Trends and Disparities in CAD and AMI in the United States From 2000 to 2020
Christian Akem Dimala1, Christopher Reggio2, Marvel Changoh3
1Division of Cardiovascular Medicine, Department of Medicine, University of Texas Medical Branch, Galveston, Texas, USA.
Insights
Mortality rates for coronary artery disease (CAD) and acute myocardial infarction (AMI) significantly decreased from 2000-2020. However, disparities persist among males, older adults, and racial groups, requiring targeted interventions.
Area of Science:
- Cardiology
- Public Health
- Health Disparities
Background:
- Coronary artery disease (CAD) and acute myocardial infarction (AMI) represent a substantial healthcare burden.
- These cardiovascular conditions disproportionately affect various population subgroups.
Purpose of the Study:
- To analyze age, sex, and racial disparities in mortality rates for CAD and AMI in the United States.
- To examine trends in CAD and AMI mortality from 2000 to 2020.
Main Methods:
- Ecological study design utilizing trend analysis.
- Data sourced from National Centers for Disease Control and Prevention surveillance databases.
Main Results:
- Significant declines observed in age-standardized mortality for CAD (249.4 to 118 per 100,000) and AMI (93.4 to 34.1 per 100,000) between 2000-2020.
- Mortality rates were higher in males, individuals aged 75+, and non-Hispanic Blacks (NHBs) and non-Hispanic Whites (NHWs) compared to Hispanics.
- CAD mortality was higher in NHBs than NHWs, but no significant difference was found for AMI mortality between these groups.
Conclusions:
- Despite overall mortality reduction, a deceleration in decline post-2011 indicates a need for new intervention targets.
- Persistent disparities among specific demographics highlight the necessity for targeted public health policies and interventions.
Background:
Coronary artery disease (CAD) and acute myocardial infarction (AMI) still pose a significant burden to the health care system, affecting population subgroups differently.
Objectives:
The purpose of the study was to describe age, sex, and racial disparities in mortality rates for CAD and AMI in the United States between 2000 and 2020.
Methods:
This was an ecological study with trend analysis of mortality rates using data from the National Centers for Disease Control and Prevention surveillance databases.
Results:
Between 2000 and 2020, there was a significant decrease in the age-standardized mortality rates of both CAD (from 249.4 to 118 per 100,000 cases [P < 0.001]) and AMI (from 93.4 to 34.1 per 100,000 cases [P < 0.001]), with deceleration in the decline of mortality rates after 2011. CAD and AMI mortality rates were both significantly higher in males (P < 0.001), the 75+ years age group (P < 0.001), and in non-Hispanic Blacks (NHBs) and non-Hispanic Whites (NHWs) compared to Hispanics (P < 0.001). While CAD mortality rates were higher in NHB compared to NHW (P = 0.037), there was no significant difference in AMI mortality rates between NHB and NHW (P = 0.144). There was also no difference in both CAD and AMI mortality rates between the 25 to 44 years and 45 to 64 years age groups (P = 0.051 and P = 0.072).
Conclusions:
While a significant reduction in mortality rates is evident, the notable deceleration in this decline in recent years reflects a plateauing of earlier gains and highlights the need to identify new targets. The persistent disparities in the identified population subgroups necessitate further exploration to inform targeted interventions and policies.
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