Abstract 4143848: Trends in Ischemic Cardiomyopathy related mortality among older adults in US population: A CDC WONDER database analysis from 1999 to 2020

Introduction: Ischemic cardiomyopathy (IC) is a significant contributor to cardiovascular mortality, especially among older adults in the United States. Understanding mortality trends related to IC can help identify at-risk populations and make informed targeted healthcare strategies. This study investigates IC-related mortality trends and disparities among older adults aged ≥75 years in the US population. Methods: The CDC Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) was used to analyze the National Vital Statistics System data from 1999 to 2020. Deaths with IC as the primary cause of mortality were identified, and results were presented as age-adjusted mortality rates (AAMR) per 100,000 population. Joinpoint regression was used to assess changes in trends and annual percentage change (APC). Results: A total of 186,136 deaths occurred in patients with IC from 1999 to 2020 (AAMR = 42.9, 95% CI: 42.7 - 43.2). Males had higher mortality rates (AAMR = 67.8) compared to females (AAMR = 27.7). Non-Hispanic Whites (NHW) had the highest AAMR (45.2, 95% CI: 45-45.4), followed by Hispanics (29.8, 95% CI: 29.1-30.5), non-Hispanic Blacks (NHB) (29.6, 95% CI: 29-30.1), non-Hispanic American Indian/Alaska Native (NH-AIAN) (29.1, 95% CI: 26.8-31.3). Non-Hispanic Asian/Pacific Islanders (NH-API) had the lowest AAMR (16.9, 95% CI: 16.2-17.6). Regionally, the South had the highest mortality rates (47.8, 95% CI: 47.5-48.2), followed by the Midwest (47.4, 95% CI: 46.9-47.8), the West (36.7, 95% CI: 36.3-37.1), and the Northeast (36.3, 95% CI: 35.9-36.7). Mortality rates were higher in rural areas (44.1, 95% CI: 43.5-44.7) compared to urban areas (36.5, 95% CI: 36.1-36.8). Overall, the AAMR increased from 51.3 in 1999 to 51.9 in 2005, followed by a decline to 31.5 in 2020 (APC: -2.0, 95% CI: -2.2, -1.7). Noteworthy declines in AAMR were observed in both men (APC: -2.0) and women (APC: -2.9) throughout the study (Figure, Panel A). Moreover, significant downward trends were evident in NH-AIAN (APC: -3.5), NHB (APC: -1.2), NHW (APC: -2.7 since 2004), Hispanics (APC: -5.5 since 2016), and NH-API (APC: -2.4) racial groups (Figure, Panel B). Conclusion: Our study reveals disparities in IC-related mortality, highlighting males, NHW, and the residents in the South and Midwest as well as those living in rural areas are at increased risk. Targeted interventions and resource allocation are essential to improve outcomes for vulnerable populations.