SAT-415 Evolving Mortality Trends in Thyrotoxicosis-Related Ischemic Heart Disease Before and During the COVID-19 Pandemic: A 24-year Retrospective Study Using CDC-WONDER dataset

Abstract Disclosure: V. Gill: None. S. Govekar: None. S. Soni: None. H. Luo: None. Introduction: Thyrotoxicosis (TT), a condition characterized by elevated thyroid hormone levels, has a substantial impact on cardiovascular health, particularly ischemic heart disease (IHD). The COVID-19 pandemic has disrupted healthcare systems and patient outcomes, potentially altering mortality trends in individuals with concurrent TT and IHD. Despite its clinical relevance, research on this topic remains limited. To our knowledge, this is the first study to address this gap by analyzing trends in TT-related IHD mortality before the pandemic (up to 2019) and during the pandemic era (2020 onwards) using data from the CDC WONDER database. Mortality trends were examined across sex, race, urbanization, and age, providing novel insights into shifting patterns. Methods: We performed a retrospective analysis using CDC WONDER mortality data, focusing on TT and IHD deaths across two time periods: up to 2019 and from 2020 onwards. Mortality data were identified using ICD-10 codes (IHD: I20-I25; TT: E05.x) and stratified by age, sex, race/ethnicity, urban-rural status, and region. Crude and age-adjusted mortality rates (AAMRs) per 100,000 population, standardized to the 2000 U.S. Census, were calculated. Temporal trends were analyzed using Joinpoint regression to estimate annual percent changes (APCs). Statistical comparisons, including t-tests, were employed to assess differences between the two periods, with significance set at p < 0.05. Results: Prior to 2020, TT accounted for 0.055% of IHD deaths, with male and female rates of 0.032% and 0.083%, respectively. Post-2020, the proportion of TT-related IHD deaths increased to 0.061%, with a significant rise observed among males (p=0.031). AAMRs declined significantly from 0.0594 to 0.0529 (p=0.0106), though recent trends indicate rising mortality in younger groups, particularly males aged 65-74 (32.3%). Racial disparities were evident, with an increase in Black or African American deaths from 11.8% to 13.6%. Urbanization trends showed a decrease in Metro deaths (83.6% to 78.8%) and a corresponding rise in Non-Metro deaths (16.4% to 21.2%). Conclusion: This study identifies significant changes in TT-related IHD mortality patterns during the pandemic, including a notable increase in mortality among males (p=0.031) and a shift toward younger age groups, particularly males aged 65-74. Despite a significant decline in AAMRs (p=0.0106), demographic disparities—such as an increased proportion of deaths among Black or African American individuals and a geographic shift toward Non-Metro areas—remain evident.These findings underscore the importance of targeted strategies to address demographic and geographic inequities in TT-related IHD outcomes in the context of evolving healthcare challenges. Presentation: Saturday, July 12, 2025