Abstract 4145450: Trends in Heart Failure Mortality Among Adults with Chronic Ischemic Heart Disease in the United States from 1999 to 2020

Introduction: The previous literature identifies chronic ischemic heart disease (CIHD) as a major contributor to heart failure (HF), accelerating its progression due to reduced coronary perfusion and decreased myocardial contractility. Significant disparities in mortality rates persist despite advancements in treatment,. This study characterizes trends in mortality across various demographics in the US. Methods: CDC Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) was used to identify HF-related mortality in patients with underlying CIHD from 1999-2020. Results were presented as age-adjusted mortality rates (AAMR) per 100,000 population. Joinpoint regression was used to calculate annual percentage change (APC). Results: A total of 2,165,216 deaths occurred in patients with CIHD due to HF from 1999-2020 (AAMR = 37.3, 95% CI: 37.3-37.4). AAMR decreased from 51.8 in 1999 to 31.9 in 2012, then increased to 35.1 in 2020 (APC: 5.1). Increased mortality rates were observed in males (AAMR = 49.8) compared to females (AAMR = 24.4) (Figure, Panel A). AAMRs were highest in Non-Hispanic (NH) Whites (38.5, 95% CI: 38.5–38.6), followed by NH blacks (32.0, 95% CI: 31.8-32.1), NH American Indian/Alaska Native (28.8, 95% CI: 28.3–29.5) and Hispanics (26.6, 95% CI: 26.6–26.7). NH Asian/Pacific Islanders had the lowest mortality rates (17.3, 95% CI: 17.1–17.5) (Figure, Panel B). We observed that mortality rates were highest in the Midwest region (40.1, 95% CI: 39.9 – 40.1). The West region reported mortality rates of 37.3 (95% CI: 37.2 – 37.4), followed closely by the South region (AAMR = 36.3, 95% CI: 36.3 – 36.4) while the Northeast reported the lowest mortality rate (AAMR = 35.7, 95% CI: 35.6 – 35.8). (Figure, Panel C). Rural areas had higher mortality rates than urban areas (Rural: 44.5, 95% CI: 44.3–44.7; Urban: 33.9, 95% CI: 33.8–34). Conclusion: Despite recent improvements, HF-CIHD-related mortality has shown a rise in recent years. AAMR increased among men, NHW, NHB, NH-API, Hispanics, the Midwest region, and rural areas. These results emphasize the necessity for focused interventions and strategic allocation of healthcare resources to address these disparities and enhance outcomes for vulnerable populations.