S1544 Unraveling Trends and Disparities in Myocardial Infarction-Related Mortality Among Inflammatory Bowel Disease Patients in the United States: A CDC WONDER Database Analysis

Introduction: Patients with Inflammatory Bowel Disease (IBD) are at increased risk for myocardial infarction (MI) due to chronic systemic inflammation, shared cardiovascular risk factors, and treatment-related complications. However, trends and disparities in MI-related mortality among IBD patients in the United States (US) remain underexplored. Methods: This CDC WONDER database study analyzed death certificates from 1999 to 2020, identifying US residents (Age Group) with IBD (International Classification of Diseases-10-CM K51, K52) who had myocardial infarction (International Classification of Diseases-10: I21) listed as the underlying cause. Age-adjusted mortality rates (AAMRs) and annual percent changes (APCs) were calculated using Joinpoint regression and stratified by gender, age, race, and urban-rural classification. Results: Between 1999 and 2020, 2,975 deaths were attributed to MI in patients with underlying IBD (males: 1,496; females: 1,479). The overall AAMR declined from 0.054 in 1999 to 0.027 in 2017, and then increased slightly to 0.039 in 2020. The trend showed a significant decline between 1999 and 2017 (APC: −3.95%; 95% CI: −7.49 to −2.75), followed by a non-significant rise between 2017 and 2020 (APC: +14.02%). The overall mortality rate reduced over time (AAPC: −1.56%; 95% CI: −3.30 to −0.41). AAMRs were higher in males (0.043) compared to females (0.026). Racial disparities were evident: White individuals had the highest AAMRs (0.060), followed by Hispanic (0.049), Black (0.045), and Asian/Pacific Islanders (0.008). Nonmetropolitan counties experienced higher mortality rates compared to metropolitan counties (0.046 vs 0.037). Conclusion: While MI-related mortality among IBD patients has decreased from 1999 to 2017, a concerning rising pattern of MI mortality can be observed in recent years. Marked disparities exist by gender, race, and geographic location, highlighting the need for targeted cardiovascular risk mitigation in these population groups. Additional studies are necessary to further identify the underlying risk factors, including access to health care and disease-related pathophysiology.