Temporal trends and disparities in cardiac arrest and co-listed acute myocardial infarction-related mortality in the United States, 1999–2025: Insights from CDC WONDER database

Abstract Cardiac Arrest (CA) and Acute Myocardial Infarction (AMI) are closely linked cardiovascular conditions and major contributors to global mortality. We evaluated national trends in mortality associated with CA co-listed with AMI among United States (U.S) adults from 1999 to 2025 and assessed demographic and geographic disparities. Using CDC WONDER Multiple Cause of Death, we conducted a retrospective analysis of CA and co-listed AMI-related mortality from 1999 to 2025 among adults aged ≥ 25 years. Age-adjusted mortality rates (AAMRs) were calculated, and joinpoint regression was utilized to estimate annual average percentage changes (AAPCs) with 95% confidence intervals (CIs). There were 747,073 reported deaths due to CA and co-listed AMI. The AAMR decreased from 22.06 in 1999 to 7.37 in 2025 (AAPC: −4.28; p ≤ 0.000001). Men had higher mean AAMRs than women (mean AAMR: men 16.38; women: 9.77). Among races, Non-Hispanic (NH) Black individuals had the highest mean AAMR (17.14). Mortality burden was greatest among older adults aged ≥ 65 years (mean AAMR: 51.35). Regionally, the Northeast had the highest mean AAMR (16.29), and rural areas showed slightly higher mortality compared with urban areas (14.29 vs. 13.53). Most deaths (69.22%) occurred in medical facilities. Mortality associated with CA and co-listed AMI has declined substantially in the U.S over the past two decades, with significant disparities. These findings highlight the importance of improved risk stratification and targeted preventive strategies in high-risk populations.