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Mortality Trends from Acute MI with Underlying CKD in the US from 1999 to 2020: A Cross-Sectional Analysis of the CDC

Rayyan Nabi1, Muhammad Hussain Mansoor2, Muhammad Hassan Shahbaz2

  • 1Islamic International Medical College, Riphah International University, Islamabad, Pakistan.

International Urology and Nephrology
|August 26, 2025
PubMed

Insights

Mortality from acute myocardial infarction (heart attack) in chronic kidney disease patients has decreased. However, significant disparities persist among different genders, races, and geographic locations.

Area of Science:

  • Cardiovascular Medicine
  • Nephrology
  • Public Health

Background:

  • Chronic kidney disease (CKD) is a significant risk factor for acute myocardial infarction (AMI), leading to poorer patient outcomes.
  • Despite advancements in cardiovascular care, disparities in mortality rates persist across various demographic groups.

Purpose of the Study:

  • To examine trends in AMI-related mortality among CKD patients in the United States.
  • To identify and analyze disparities in AMI-related mortality based on sex, race/ethnicity, and geographic factors from 1999 to 2020.

Main Methods:

  • Analysis of national mortality data from the CDC WONDER database (1999-2020).
  • Identification of deaths with AMI (ICD-10 codes I21-I22) as the primary cause and CKD (ICD-10 N18) as a contributing factor.
  • Calculation of age-adjusted mortality rates and assessment of trends using Joinpoint regression.

Main Results:

  • A total of 72,780 AMI-related deaths occurred in CKD patients (aged 25-85).
  • Overall age-adjusted mortality rates declined from 2.46 in 1999 to 0.99 in 2020 (APC: -4.09%).
  • Higher mortality rates were observed in men, Non-Hispanic Black individuals, and those in nonmetropolitan areas. A notable increase in mortality was seen among Hispanic patients from 2015-2020.

Conclusions:

  • While overall AMI-related mortality in CKD patients has decreased, significant disparities persist.
  • Targeted interventions are crucial to address the persistent inequalities in outcomes based on sex, race/ethnicity, and geographic location.
Abstract

Keywords:
Acute myocardial infarctionCDC WONDERChronic kidney diseaseHealth disparitiesMortality trends

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