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Published on: June 12, 2021
Trends in Mortality Among Adults With Acute Myocardial Infarction With Cardiogenic Shock in the United States,
Abdullah Naveed Muhammad1, Sivaram Neppala2, Himaja Dutt Chigurupati3
1Department of Cardiology, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
Insights
Mortality from cardiogenic shock (CS) in acute myocardial infarction (AMI) patients decreased overall but increased from 2011-2021. Significant disparities exist among men, Hispanic individuals, and rural populations, requiring targeted interventions.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Cardiogenic shock (CS) is a severe complication of acute myocardial infarction (AMI) associated with high mortality.
- Existing data on mortality trends for CS in AMI patients are insufficient.
- Understanding demographic patterns and mortality statistics is crucial for targeted interventions.
Purpose of the Study:
- To analyze trends in mortality rates associated with cardiogenic shock among patients with acute myocardial infarction.
- To identify demographic, regional, and socioeconomic disparities in CS mortality.
- To provide data for developing strategies to reduce CS-related deaths in AMI patients.
Main Methods:
- Utilized data from the CDC's Wide-ranging ONline Data for Epidemiologic Research (1999-2023).
- Evaluated mortality related to CS in AMI patients aged 25 years and older.
- Calculated age-adjusted mortality rates (AAMR) and average annual percentage changes using JoinPoint regression analysis.
Main Results:
- Cardiogenic shock caused 187,838 deaths among AMI patients (25+ years) from 1999-2023.
- Overall AAMR decreased from 5.4 to 3.3 per 100,000, with an annual change of -2.02%.
- Mortality increased from 2011-2021 (3.32% annually), with higher rates in men, Hispanic individuals, and rural areas.
Conclusions:
- A recent rise in CS mortality (2011-2021) and persistent disparities necessitate urgent attention.
- Targeted interventions are needed to address higher mortality in men, Hispanic individuals, and rural populations.
- Improving healthcare access and implementing focused strategies can mitigate CS-related mortality in AMI patients.
Background:
Cardiogenic shock (CS) elevates mortality rates among patients with acute myocardial infarction (AMI), yet there are insufficient data on trends in mortality. This study seeks to elucidate demographic patterns and mortality statistics.
Methods:
We analyzed data from the Centers for Disease Control and Prevention's Wide-ranging ONline Data for Epidemiologic Research (1999-2023) to evaluate mortality related to CS among AMI patients aged 25 years and above. Age-adjusted mortality rates (AAMR) per 100,000 patients and average annual percentage changes were calculated using JoinPoint regression analysis to explore mortality trends.
Results:
Cardiogenic shock contributed to 187,838 deaths among AMI patients aged 25 years and older. Between 1999 and 2023, the AAMR fell from 5.4 to 3.3 per 100,000, reflecting an average annual percentage change of -2.02. The most significant reduction occurred from 1999 to 2011, followed by a notable increase from 2011 to 2021 (annual percent change, 3.32). Disparities are apparent, as men have higher AAMR than women (4.5 vs 2.5), with Hispanic individuals at the most significant risk (AAMR, 3.5), followed by Whites (AAMR, 3.4). Regionally, West Virginia has the highest AAMR at 5.3, whereas Minnesota has the lowest at 2.3. Additionally, rural areas report higher AAMR than urban ones (4.0 vs 3.2).
Conclusions:
The recent increase in mortality rates between 2011 and 2021 due to CS in AMI and disparities among men, Hispanic individuals, and people living in rural areas-calls for urgent attention. By applying focused interventions and improving health care access, we can bridge these gaps and enhance patient outcomes.
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