Abstract 4147421: Disparities in Myocardial Infarction Mortality among Patients with Chronic Obstructive Pulmonary Diseases: A 22-Year Retrospective Analysis

Background: COPD and cardiovascular disease (CVD) share common risk factors. Myocardial Infarction (MI) is a major cause of death in patients with COPD; however, temporal, sex-based, racial, and geographic variations in mortality are poorly defined. Methods: We conducted a retrospective analysis using the CDC WONDER dataset, extracting age-adjusted mortality rates (AAMR) per 100,000, calculating the annual percentage change (APC) and its weight average, the average annual percentage change (AAPC) through Joinpoint regression. The results were stratified to identify temporal, sex-based, racial, and geographic variations in mortality. Results: From 1999–2020, a total of 191,215 deaths among adults over 25 years old with COPD were attributed to MI. During this period, the AAMR declined significantly, from 6.83 to 2.76, reflecting an average annual percentage change (AAPC) of -4.54% (95% CI: -4.79 to -4.31). Males exhibited a higher AAMR (5.57; 95% CI 5.54 to 5.60) than females (2.88; 95% CI 2.86 to 2.90). Both sexes experienced a marked decline in AAMR over the study duration. Non-Hispanic (NH) Whites had the highest AAMR (4.43), followed by NH blacks (3.03), NH American Indians/Alaskan Natives (3.57), Hispanics or Latinos (1.90), NH Asians/Pacific Islanders had the lowest AAMR (1.28). Significant state-wise variations were observed, with AAMRs ranging from a high of 7.57 in West Virginia to a low of 1.47 in Hawaii. Three states—Arkansas, New Mexico, and South Dakota—reported an overall increase in AAMRs over the study duration. Regionally, the Midwest exhibited the highest AAMRs (4.52), while the Northeast had the lowest (3.51). Additionally, micropolitan (5.89) and noncore (6.30) areas experienced higher AAMRs compared to large central metropolitan areas (3.14). Conclusion: Mortality from acute MI in patients with COPD has decreased overall. However, certain sociodemographic groups have not secured the same deceleration in mortality. Opportunities to decrease COPD-related death rates still exist.