Abstract 4145992: Mortality Trends of Chronic Obstructive Pulmonary Disease and Acute Myocardial Infarction in the United States

Introduction: Given the overlap in their risk factors, investigating the combined mortality trends of both chronic obstructive pulmonary disease (COPD) and acute myocardial infarction (AMI) represents a crucial yet understudied area. Methods: Using the CDC WONDER database, we queried mortality records from 1999 to 2019 among COPD-related deaths (ICD-10: J40, J41, J42, J43, J44) and AMI-related deaths (ICD-10: I21) in ≥ 45-years-old. Joinpoint regression analysis was utilized to assess trends in annual percentage change (APC) for underlying and contributing causes of death. Age-adjusted mortality rates (AAMR) were computed and compared cumulatively across subpopulation demographics. Results: Between 1999 and 2007, COPD and AMI mortality as underlying causes showed a notable decline (APC: -4.71, 95% CI: -6.09, -3.45), with a continued decrease from 2007 to 2020 (APC: -2.28, 95% CI: -2.61, -1.57). Conversely, as contributing causes, COPD and AMI demonstrated a downward trend from 1999 to 2009 (APC: -3.09, 95% CI: -4.22, -2.45), followed by a slower decline from 2009 to 2018 (APC: -1.52, 95% CI: -3.3, -0.93), and a slight increase from 2018 to 2020 (APC: 2.05, 95% CI: -1.18, 3.75). Gender-specific analysis revealed consistently higher AAMRs among males (458.8) than females (295.5), while Whites consistently had the highest AAMR (377.6) and Asians the lowest (145.9). Urbanization level played a role, with non-metropolitan areas consistently exhibiting higher AAMR (478.5) compared to metropolitan areas (353.1), with the Midwest showing the highest AAMR (396.1). Conclusion: The decline in COPD and AMI-related mortality reflects the success of public health initiatives targeting smoking cessation, improved air quality regulations, and advancements in cardiovascular care. The uptick in mortality rates from 2018 to 2020 underscores the necessity for ongoing vigilance and targeted interventions, especially in addressing disparities related to gender, race, and urbanization.