Abstract DP132: Trends In Mortality Related To Stroke And Cardiogenic Shock In Adults In The US From 1999-2023: A CDC WONDER Analysis

Introduction: Cardiogenic shock and stroke are interconnected acute conditions in which each can precipitate the other, amplifying morbidity and mortality. Stroke can trigger heart dysfunction through neurogenic stress cardiomyopathy, catecholamine surges, and arrhythmias, potentially leading to cardiogenic shock. Conversely, cardiogenic shock impairs cerebral perfusion and increases the risk of embolism, which can cause stroke. This bidirectional relationship worsens outcomes, with stroke occurring in up to 13% of cardiogenic shock cases and cardiogenic shock developing in up to 15% of patients with stroke. We intend to analyze the patterns of mortality due to stroke and cardiogenic shock across various demographics and regions. Methods: We analyzed mortality due to cardiogenic shock (ICD-10 code: R57) and stroke (ICD-10 code: I60-I69) using the CDC-WONDER database from 1999 to 2023. Age-Adjusted Mortality Rates (AAMR) per 100,000 were calculated and categorized by demographics and region. Joinpoint regression was used to estimate the Annual Percent Change (APC) and Average Annual Percent Change (AAPC) in AAMR. Results: A total of 41,047 deaths were attributed to stroke and cardiogenic shock between 1999 and 2020 in the NCHS database. The AAMR first decreased from 1.22 in 1999 to 0.8 in 2004 (APC: -7.89; 95% CI: -9.83 to -5.9; p=0.000001), followed by another significant decrease to 0.68 in 2012 (APC: -2.92; 95% CI: -4.34 to -1.46; p=0.0007). The AAMR then increased steadily to 1.19 in 2020 (APC: 7.48; 95% CI: 6.42 to 8.56; p<0.000001). Men had a higher overall AAMR than women (0.86 vs. 0.77). Non-Hispanic (NH) Black individuals showed the highest AAMR (1.5), followed by NH Whites (0.86), and NH Asians and Hispanic individuals (both 0.81). Non-metropolitan areas had a higher AAMR than metropolitan areas (0.99 vs. 0.84). Conclusion: Mortality from stroke and cardiogenic shock declined initially from 1999 to 2012 but rose steadily thereafter, reflecting an aging population, increasing prevalence of cardiovascular risk factors, and delayed presentation or access to timely care. Significant disparities were noted, with men, non-Hispanic Black individuals, and non-metropolitan residents experiencing the highest rates. These findings highlight persistent demographic and geographic disparities and emphasize the need for targeted interventions and integrated cardiovascular–cerebrovascular care to reduce mortality in high-risk populations.