TY - JOUR
T1 - Trends in Premature Mortality From Acute Myocardial Infarction in the United States, 1999 to 2019
AU - Dani, Sourbha S.
AU - Lone, Ahmad N.
AU - Javed, Zulqarnain
AU - Khan, Muhammad S.
AU - Khan, Muhammad Zia
AU - Kaluski, Edo
AU - Virani, Salim S.
AU - Shapiro, Michael D.
AU - Cainzos-Achirica, Miguel
AU - Nasir, Khurram
AU - Khan, Safi U.
N1 - Funding Information:
S.S.V. has received research support from the Department of Veterans Affairs, World Heart Federation, Tahir, and Jooma Family Honorarium. He is Associate Editor for the American College of Cardiology (innovations, https://www.acc.org/). M.D.S. is on advisory activities with Amgen, Alexion, Esperion, and Novartis. K.N. serves as a consultant for Amgen, Novartis, and Novo Nordisk. The remaining authors have no disclosures to report.
Publisher Copyright:
© 2021 The Authors.
PY - 2022/1/4
Y1 - 2022/1/4
N2 - BACKGROUND: Evaluating premature (<65 years of age) mortality because of acute myocardial infarction (AMI) by demographic and regional characteristics may inform public health interventions. METHODS AND RESULTS: We used the Centers for Disease Control and Prevention’s WONDER (Wide-Ranging Online Data for Epidemiologic Research) death certificate database to examine premature (<65 years of age) age-adjusted AMI mortality rates per 100 000 and average annual percentage change from 1999 to 2019. Overall, the age-adjusted AMI mortality rate was 13.4 (95% CI, 13.3–13.5). Middle-aged adults, men, non-Hispanic Black adults, and rural counties had higher mortality than young adults, women, NH White adults, and urban counties, respectively. Between 1999 and 2019, the age-adjusted AMI mortality rate decreased at an average annual percentage change of −3.4 per year (95% CI, −3.6 to −3.3), with the average annual percentage change showing higher decline in age-adjusted AMI mortality rates among large (−4.2 per year [95% CI, −4.4 to −4.0]), and me-dium/small metros (−3.3 per year [95% CI, −3.5 to −3.1]) than rural counties (−2.4 per year [95% CI, −2.8 to −1.9]). Age-adjusted AMI mortality rates >90th percentile were distributed in the Southern states, and those with mortality <10th percentile were clustered in the Western and Northeastern states. After an initial decline between 1999 and 2011 (−4.3 per year [95% CI, −4.6 to −4.1]), the average annual percentage change showed deceleration in mortality since 2011 (−2.1 per year [95% CI, −2.4 to −1.8]). These trends were consistent across both sexes, all ethnicities and races, and urban/rural counties. CONCLUSIONS: During the past 20 years, decline in premature AMI mortality has slowed down in the United States since 2011, with considerable heterogeneity across demographic groups, states, and urbanicity. Systemic efforts are mandated to ad-dress cardiovascular health disparities and outcomes among nonelderly adults.
AB - BACKGROUND: Evaluating premature (<65 years of age) mortality because of acute myocardial infarction (AMI) by demographic and regional characteristics may inform public health interventions. METHODS AND RESULTS: We used the Centers for Disease Control and Prevention’s WONDER (Wide-Ranging Online Data for Epidemiologic Research) death certificate database to examine premature (<65 years of age) age-adjusted AMI mortality rates per 100 000 and average annual percentage change from 1999 to 2019. Overall, the age-adjusted AMI mortality rate was 13.4 (95% CI, 13.3–13.5). Middle-aged adults, men, non-Hispanic Black adults, and rural counties had higher mortality than young adults, women, NH White adults, and urban counties, respectively. Between 1999 and 2019, the age-adjusted AMI mortality rate decreased at an average annual percentage change of −3.4 per year (95% CI, −3.6 to −3.3), with the average annual percentage change showing higher decline in age-adjusted AMI mortality rates among large (−4.2 per year [95% CI, −4.4 to −4.0]), and me-dium/small metros (−3.3 per year [95% CI, −3.5 to −3.1]) than rural counties (−2.4 per year [95% CI, −2.8 to −1.9]). Age-adjusted AMI mortality rates >90th percentile were distributed in the Southern states, and those with mortality <10th percentile were clustered in the Western and Northeastern states. After an initial decline between 1999 and 2011 (−4.3 per year [95% CI, −4.6 to −4.1]), the average annual percentage change showed deceleration in mortality since 2011 (−2.1 per year [95% CI, −2.4 to −1.8]). These trends were consistent across both sexes, all ethnicities and races, and urban/rural counties. CONCLUSIONS: During the past 20 years, decline in premature AMI mortality has slowed down in the United States since 2011, with considerable heterogeneity across demographic groups, states, and urbanicity. Systemic efforts are mandated to ad-dress cardiovascular health disparities and outcomes among nonelderly adults.
KW - Acute myocardial infarction
KW - Epidemiology
KW - Mortality
KW - Humans
KW - Middle Aged
KW - Male
KW - Young Adult
KW - Mortality, Premature
KW - Ethnicity
KW - Myocardial Infarction
KW - United States/epidemiology
KW - Rural Population
KW - Female
KW - Racial Groups
UR - http://www.scopus.com/inward/record.url?scp=85123255921&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85123255921&partnerID=8YFLogxK
U2 - 10.1161/JAHA.121.021682
DO - 10.1161/JAHA.121.021682
M3 - Article
C2 - 34935456
AN - SCOPUS:85123255921
SN - 2047-9980
VL - 11
SP - e021682
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 1
M1 - e021682
ER -