Abstract 4361739: Mortality Patterns of Atrial Fibrillation Among Adults with Renal Disease in the United States, 1999–2023: Evidence from the CDC WONDER Database

Background: Atrial fibrillation (AF) and renal diseases frequently coexist, posing significant challenges in clinical management. The interplay between these conditions can exacerbate hemodynamic instability and influence treatment outcomes. This study aims to assess or evaluate the impact of renal diseases on mortalities and disparities in patients with AF. Objective: We hypothesize that there are disparities in mortalities due to AF and among individuals with renal diseases in the United States of America (USA) based on age, gender, race, and census region. Methods: We analyzed adults aged >25 years death certificates from the CDC-WONDER database with AF (ICD-10 codes: I48) and renal diseases (ICD-10 codes: N17-N19 AND N28.9) from 1999-2023. Age-adjusted mortality rates (AAMR) per 100,000 population were stratified by gender, race, census region, and year. Join-Point analysis was performed to estimate annual percent change (APC) and average annual percent change (AAPC) in mortality trends. Results: Between 1999 and 2023, AF and renal diseases caused 372,652 deaths in adults aged >25 years. The AAMR first increased from 16.67 in 1999 to 44.07 in 2012 (APC: 5.88, 95% CI: 3.91-7.88), decreased to 32.1 in 2015 (APC: -8.42; 95% CI: -32.51 to 24.25) and finally increased to 54.45 in 2023 (APC: 9.34; 95% CI: 6.54-12.22) with an overall AAPC (5.09; 95% CI: 1.22-9.12). From 1999 to 2023, AAMR for males (23.01-68.92) was higher than that of females (13.16-44.24). From 1999 to 2023, Non-Hispanic (NH) White displayed the highest AAMR (17.12-59.63), followed by NH Black or African American (15.71-49.1), Hispanic or Latino (10.05-30.53), and NH Asian or Pacific Islander (14.31-26.73). Geographically from 1999 to 2023, South region showed highest AAPC (5.61), followed by Midwest (4.81), West (4.48), and Northeast (4.18). Rural areas exhibited higher AAPC (3.81) than urban areas (3.22). Conclusion: AF and renal diseases-related mortality has increased, with highest rates among males, White individuals, and those in Southern and rural U.S., requiring targeted, equitable public health strategies.