SUN-247 Trends and Disparities in Cardiomyopathy Associated Mortality Among Individuals with Diabetes in the United States from 1999 to 2020 - A CDC Wonder Analysis.

Abstract Disclosure: F. Ahmed: None. F. Fatima: None. M. Fatima: None. M. Abid: None. A. Raza: None. M. Ali: None. A. Zafar Masood: None. H. Abid: None. A. Fayyaz: None. M. Kakakhel: None. I. nayyab: None. H. Zahid: None. N. Gohar: None. K. Aman: None. T. Mirza: None. H. Ahmad: None. A. Ullah: None. R. Haider: None. M. Bakr: None. S. Eltawansy: None. O.M. Kamel: None. Background: Diabetes is one of the biggest risk factors for cardiovascular diseases including Diabetic Cardiomyopathy (DC). Main reason is formation of hyperglycemia-induced advanced glycation end-products (AGEs) and inflammation causing myocardial fibrosis. As global prevalence of diabetes is increasing, it is important to explore the mortality trends due to DC across various epidemiological groups. Methods: This study is based on in-depth search of the CDC WONDER database (1999-2020) involving ICD-10 Codes: E10-E14 and I42 using Age-Adjusted Mortality Rate (AAMR) per 1,000,000 individuals. Join point regression (Version 5.1.0, National Cancer Institute) was used to assess Parallelism, Annual Percent Changes (APC) and Average Annual Percent Changes (AAPCs) with a 95% Confidence Interval. The parallelism test shows trends between two groups are not parallel if p<0.05. Results: A total of 148328 deaths were reported from 1999 to 2020. From 1999 to 2001, there was a slight rise in AAMR (APC:0.26%) followed by a significant decline from 2001 to 2018 (APC: -3.96%) and then a sharp increase from 2018 to 2020 (APC: 8.18%). The AAMR of males (27.65) was higher than females (14.27) with significant parallelism test and AAPC difference of -1.53(95%CI -2.59 to -0.47, p<0.005). Midwest had the highest AAMR (21.58) followed by South (20.46), West (20.29) and Northeast (17.41). Midwest had lowest decreasing trend with AAPC of -2.15(95%CI -3.07 to -1.23, p<0.005) while Northeast had highest decrease with AAPC of -3.21(95%CI -4.38 to -2.02, p<0.001). The AAMR was highest for Non-Hispanic Blacks (36.17) and lowest for Asians (14.42). The highest decreasing trend was seen in American Indians with AAPC of -3.91(95%CI -6.11 to -1.65, p <0.005) and NH Blacks had the lowest decrease with AAPC of -2.89(95%CI -4.11 to -1.67, p<0.005). The parallelism test was significant for Asian vs White (p=0.012) and Asian vs American Indians (p=0.007). The AAMR was highest for Hawaii (38.03) and lowest for Colorado (10.33). Crude rate was highest for the 85+ years age group ranging from 22.79 in 1999 to 17.07 in 2020. AAMR was higher in non-metropolitan areas (20.92) than metropolitan (19.91). The decrease in mortality was more in metropolitan having AAPC of -2.67(95%CI -3.26 to -2.07, p<0.001) than in non-metropolitan with AAPC of -1.89(95%CI -3.09 to -0.67, p<0.005) with significant parallelism (p=0.007). Conclusion: The mortality trend due to DC exhibited a modest rise from 1999 to 2001, then a decline until 2018 and a subsequent increase till 2020. Males, Midwest, Black and non-metropolitan areas had the highest AAMRs. Our findings highlight the need for tailored interventions to reduce incongruities across different epidemiological groups. Presentation: Sunday, July 13, 2025