Trends in Acute Myocardial Infarction Mortality Among Patients With Chronic Kidney Disease in the United States (1999–2024): A CDC WONDER Database Analysis

Chronic kidney disease (CKD) significantly increases the risk of acute myocardial infarction (AMI)-related mortality by accelerating atherosclerosis and impairing cardiovascular outcomes. This study analyzes long-term trends in AMI mortality among patients with CKD in the United States from 1999 to 2024. We used the Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research database to identify death certificates of individuals aged ≥45 years from 1999 to 2024, listing AMI as the underlying and CKD as a contributing cause of death. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated, and annual percent changes were determined using Joinpoint regression analysis. A total of 81,465 deaths were attributed to AMI in patients with CKD. The overall AAMR declined from 4.5 in 1999 to 1.5 in 2024, with a temporary increase between 2009 and 2012 (annual percent change: 18.03; P < 0.05). Males had consistently higher AAMRs (3.8) than females (2.0), and non-Hispanic African Americans (5.2) experienced nearly double the rates of other racial/ethnic groups. Older adults (≥65 years) had an AAMR of 6.2, 9 times higher than that of middle-aged adults (0.7). The highest rates were observed in the Western US and in nonmetropolitan areas (3.0 each). Despite an overall decline in AMI-related mortality among CKD patients over the past 2 decades, persistent disparities by age, sex, race/ethnicity, and geography remain, calling for the development of targeted and equitable approaches to reduce mortality burden across high-risk groups such as males and nonmetropolitan residents.