S1652 Two Decades of Inflammatory Bowel Disease-Related Cardiovascular Mortality in the United States: Temporal Trends and Demographic Disparities From a National Death Registry

Introduction: Despite well-documented links between IBD and cardiovascular events, long-term, population-level mortality trends in this group remain unexplored. Therefore, we undertook the first comprehensive 2-decade U.S. analysis of IBD-associated cardiovascular deaths to characterize temporal shifts and uncover demographic and geographic disparities in this high-risk population. Methods: We retrospectively analyzed CDC WONDER data (1999–2020) for decedents with CVD (International Classification of Diseases-10 I00–I99) and contributory IBD (K50/K51), calculating age-adjusted mortality rates (AAMRs; direct method, 11 strata; 2000 standard) and crude mortality rates per 100,000. Rates were stratified by year, sex, race/Hispanic origin, age, state, place of death, and 2013 NCHS urbanization level; cells with <20 deaths were suppressed per CDC guidelines. Results: Between 1999 and 2020, 11,891 IBD-associated cardiovascular deaths occurred. Overall, mortality declined by –2.74% per year from 1999–2015 (95% CI –4.49 to –2.04; P = 0.0064) before a nonsignificant rebound of +3.85% from 2015–2020 (95% CI –0.24 to +13.86; P = 0.0656). Females saw a –2.99% decline (1999–2013; P = 0.0296) then plateaued (+1.76% through 2020; P = 0.3379), while males declined –3.07% (1999–2018; P = 0.0024) then rose +27.19% (2018–2020; P = 0.0100). White and Black individuals showed parallel trends: White APC –2.81% (1999–2014; P = 0.0004) then +3.12% (2014–2020; P = 0.0352); Black APC –2.82% (1999–2017; P = 0.0332) then +23.03% (2017–2020; P = 0.0416). AAMRs were highest in White (0.1672) and lowest in Asian/Pacific Islander (0.0280) populations; non‐Hispanics exceeded Hispanics (0.1657 vs 0.0385). State-level AAMRs ranged from 0.0684 in Louisiana to 0.2866 in Oregon, and urbanization-specific rates ranged from 0.1454 in large central metros to 0.1719 in small metro areas. Most deaths occurred at home (n = 3,727) or inpatient (n = 3,682), with crude mortality rising from 0.0037 (ages15–24) to 2.72 (≥85 years). Conclusion: Analysis of U.S. mortality data demonstrated a marked reduction in IBD-associated cardiovascular deaths from 1999 to 2015, followed by stabilization and a modest rebound through 2020. The disproportionate resurgence among men and Black patients underscores persistent gaps in risk mitigation and management. These findings call for individualized, multidisciplinary preventive interventions and continuous cardiovascular surveillance throughout the IBD care continuum.