Abstract 4363100: Temporal Trends in Cardiovascular Mortality Co Occurring With Hematological Malignancies Among US Adults Aged 25 to 85 From 1999 to 2023

Introduction: Adults with hematological malignancies remain at elevated risk of cardiovascular death. Understanding national trends and disparities may help inform cardio-oncology care. Methods: Using CDC WONDER Multiple Cause of Death data (1999–2023), we identified cardiovascular deaths (ICD-10: I00–I99) co-occurring with hematological malignancies (ICD-10: C81–C96) among US adults aged 25–85. Age-adjusted mortality rates (AAMRs) per 100,000 were calculated using the 2000 US standard population. Trends were assessed using Joinpoint regression, stratified by sex, race and ethnicity, region, urbanization, and age group. AAPC with 95% confidence intervals (CI) was reported; significance was set at p<0.05. Results: Between 1999 and 2023, 101,620 such deaths were recorded. Overall, AAMR declined from 2.554 to 1.787. Males had higher AAMRs than females in both years (1999: 3.586 vs 1.909; 2023: 2.544 vs 1.182). The Northeast had the highest AAMR in 1999 (2.841), while the West was highest in 2023 (1.872). The West had the lowest AAMR in 1999 (2.408); the South was lowest in 2023 (1.674). In 1999, non-Hispanic Black individuals had the highest AAMR (3.935), and NH Asian or Pacific Islander had the lowest (1.275). In 2023, NH White individuals had the highest AAMR (1.856), and NH American Indian or Alaska Native had the lowest reliable rate (0.983). AAMRs were higher in urban than rural areas in 1999 (2.589 vs 2.472); 2023 data are unavailable. Age 85+ had the highest crude rate (32.7 to 27.0); age 35–44 had the lowest (0.093 to 0.059). Overall AAPC was –1.58% (95% CI: –1.88 to –1.28). The South had the smallest regional decline (AAPC: –0.98%; 95% CI: –1.42 to –0.53). NH Asian or Pacific Islander individuals had the largest decline (AAPC: –2.30%; 95% CI: –4.00 to –0.57); NH Black individuals had the smallest (AAPC: –1.22%; 95% CI: –1.87 to –0.56). Urban areas declined more than rural (–2.14% vs –1.65%). The sharpest age decline was in 65–74 years (–2.02%); the smallest was in 45–54 years (–1.16%). Females declined more than males (–2.11% vs –1.26%). Conclusion: Cardiovascular mortality among adults with hematological malignancies has declined over time, yet disparities persist, particularly among non-Hispanic Black adults and residents of the South. These trends may reflect structural inequities in cardio-oncology access, late-stage cancer diagnoses, and insufficient survivorship planning. Targeted public health interventions are essential to reduce these disparities.