Trends in Cardiovascular Mortality Related to Atrial Fibrillation in the United States, 2011 to 2018

Background Prevalence of atrial fibrillation (AF) continues to increase and is associated with significant cardiovascular morbidity and mortality. To inform prevention strategies aimed at reducing the burden of AF, we sought to quantify trends in cardiovascular mortality related to AF in the United States. Methods and Results We performed serial cross‐sectional analyses of national death certificate data for cardiovascular mortality related to AF, whereby cardiovascular disease was listed as underlying cause of death and AF as multiple cause of death among adults aged 35 to 84 years using the Centers for Disease Control and Prevention's Wide‐Ranging Online Data for Epidemiologic Research. We calculated age‐adjusted mortality rates per 100 000 population and examined trends over time, estimating average annual percentage change using the Joinpoint Regression Program. Subgroup analyses were performed by race‐sex and across 2 age groups (younger: 35–64 years; older: 65–84 years). A total of 276 373 cardiovascular deaths related to AF were identified in the United States between 2011 and 2018 in decedents aged 35 to 84 years. Age‐adjusted mortality rate increased from 18.0 (95% CI, 17.8–18.2) to 22.3 (95% CI, 22.0–22.4) per 100 000 population between 2011 and 2018. The increase in age‐adjusted mortality rate (average annual percentage change) between 2011 and 2018 was greater among younger decedents (7.4% per year [95% CI, 6.8%–8.0%]) compared with older decedents (3.0% per year [95% CI, 2.6%–3.4%]). Conclusions Cardiovascular deaths related to AF are increasing, especially among younger adults, and warrant greater attention to prevention earlier in the life course.

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Trends in Premature Mortality From Acute Myocardial Infarction in the United States, 1999 to 2019

Journal of the American Heart Association ◽

10.1161/jaha.121.021682 ◽

2021 ◽

Author(s):

Sourbha S. Dani ◽

Ahmad N. Lone ◽

Zulqarnain Javed ◽

Muhammad S. Khan ◽

Muhammad Zia Khan ◽

...

Keyword(s):

United States ◽

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Mortality Rate ◽

The United States ◽

Mortality Rates ◽

Percentage Change ◽

Annual Percentage Change ◽

Rural Counties ◽

Average Annual Percentage Change

Background Evaluating premature (<65 years of age) mortality because of acute myocardial infarction (AMI) by demographic and regional characteristics may inform public health interventions. Methods and Results We used the Centers for Disease Control and Prevention’s WONDER (Wide‐Ranging Online Data for Epidemiologic Research) death certificate database to examine premature (<65 years of age) age‐adjusted AMI mortality rates per 100 000 and average annual percentage change from 1999 to 2019. Overall, the age‐adjusted AMI mortality rate was 13.4 (95% CI, 13.3–13.5). Middle‐aged adults, men, non‐Hispanic Black adults, and rural counties had higher mortality than young adults, women, NH White adults, and urban counties, respectively. Between 1999 and 2019, the age‐adjusted AMI mortality rate decreased at an average annual percentage change of −3.4 per year (95% CI, −3.6 to −3.3), with the average annual percentage change showing higher decline in age‐adjusted AMI mortality rates among large (−4.2 per year [95% CI, −4.4 to −4.0]), and medium/small metros (−3.3 per year [95% CI, −3.5 to −3.1]) than rural counties (−2.4 per year [95% CI, −2.8 to −1.9]). Age‐adjusted AMI mortality rates >90th percentile were distributed in the Southern states, and those with mortality <10th percentile were clustered in the Western and Northeastern states. After an initial decline between 1999 and 2011 (−4.3 per year [95% CI, −4.6 to −4.1]), the average annual percentage change showed deceleration in mortality since 2011 (−2.1 per year [95% CI, −2.4 to −1.8]). These trends were consistent across both sexes, all ethnicities and races, and urban/rural counties. Conclusions During the past 20 years, decline in premature AMI mortality has slowed down in the United States since 2011, with considerable heterogeneity across demographic groups, states, and urbanicity. Systemic efforts are mandated to address cardiovascular health disparities and outcomes among nonelderly adults.

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Abstract 15: Trends in Atrial Fibrillation-related Cardiovascular Mortality Rates in The United States: 1999-2017

Circulation ◽

10.1161/circ.141.suppl_1.15 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Cited By ~ 1

Author(s):

Yoshihiro Tanaka ◽

Nilay Shah ◽

Rod Passman ◽

Philip Greenland ◽

Sadiya Khan

Keyword(s):

United States ◽

Atrial Fibrillation ◽

Black Men ◽

Cause Of Death ◽

Age Groups ◽

White Men ◽

The United States ◽

Mortality Rates ◽

Men And Women ◽

Black And White

Background: Atrial fibrillation (AF) is the most common sustained arrhythmia in adults and the prevalence is increasing due to the aging of the population and the growing burden of vascular risk factors. Although deaths due to cardiovascular disease (CVD) death have dramatically decreased in recent years, trends in AF-related CVD death has not been previously investigated. Purpose: We sought to quantify trends in AF-related CVD death rates in the United States. Methods: AF-related CVD death was ascertained using the CDC WONDER online database. AF-related CVD deaths were identified by listing CVD (I00-I78) as underlying cause of death and AF (I48) as contributing cause of death among persons aged 35 to 84 years. We calculated age-adjusted mortality rates (AAMR) per 100,000 population, and examined trends over time estimating average annual percent change (AAPC) using Joinpoint Regression Program (National Cancer Institute). Subgroup analyses were performed to compare AAMRs by sex-race (black and white men and women) and across two age groups (younger: 35-64 years, older 65-84 years). Results: A total of 522,104 AF-related CVD deaths were identified between 1999 and 2017. AAMR increased from 16.0 to 22.2 per 100,000 from 1999 to 2017 with an acceleration following an inflection point in 2009. AAPC before 2009 was significantly lower than that after 2009 [0.4% (95% CI, 0.0 - 0.7) vs 3.5% (95% CI, 3.1 - 3.9), p < 0.001). The increase of AAMR was observed across black and white men and women overall and in both age groups (FIGURE), with a more pronounced increase in black men and white men. Black men had the highest AAMR among the younger decedents, whereas white men had the highest AAMR among the older decedents. Conclusion: This study revealed that death rate for AF-related CVD has increased over the last two decades and that there are greater black-white disparities in younger decedents (<65 years). Targeting equitable risk factor reduction that predisposes to AF and CVD mortality is needed to reduce observed health inequities.

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Trend and Geographic Disparities in the Mortality Rates of Primary Systemic Vasculitis in the United States from 1999 to 2019: A Population-Based Study

Journal of Clinical Medicine ◽

10.3390/jcm10081759 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1759

Author(s):

Alicia Rodriguez-Pla ◽

Jose Rossello-Urgell

Keyword(s):

United States ◽

Mortality Rate ◽

Cause Of Death ◽

Geographic Distribution ◽

Systemic Vasculitis ◽

The United States ◽

Mortality Rates ◽

Current Data ◽

Geographic Disparities ◽

Primary Systemic Vasculitis

The current data on rates and geographic distribution of vasculitis mortality are limited. We aimed to estimate the mortality rates of primary systemic vasculitis and its geographic distribution using recent population data in the United States. The mortality rates of vasculitis from 1999 to 2019 were obtained from the Center for Disease Control (CDC) Wonder Multiple Cause of Death (MCD). The age-adjusted rates per million for vasculitis as MCD and as an underlying cause of death (UCD) were calculated by state using demographics. A joinpoint regression analysis was applied to evaluate trends over time. The age-adjusted mortality rate of vasculitis as MCD was 4.077 (95% CI: 4.029–4.125) and as a UCD was 1.888 per million (95% CI: 1.855–1.921). Since 1999, mortality rates have progressively decreased. The age-adjusted mortality rate was higher in females than in males. The highest mortality rate for vasculitis as MCD was in White patients (4.371; 95% CI: 4.317–4.424). The northern states and areas with lower populations had higher mortality rates. We found a trend of progressive decreases in the mortality rates of vasculitis, as well as gender, racial, and geographic disparities. Further analyses are warranted to better understand the factors associated with these disparities in order to implement targeted public health interventions to decrease them.

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Demographic, Regional, and State‐Level Trends of Mortality in Patients With Aortic Stenosis in United States, 2008 to 2018

Journal of the American Heart Association ◽

10.1161/jaha.120.017433 ◽

2020 ◽

Vol 9 (21) ◽

Author(s):

Safi U. Khan ◽

Ankur Kalra ◽

Samir R. Kapadia ◽

Muhammad U. Khan ◽

Muhammad Zia Khan ◽

...

Keyword(s):

United States ◽

Aortic Stenosis ◽

The United States ◽

Percentage Change ◽

Mortality Reduction ◽

Annual Percentage Change ◽

The South ◽

The West ◽

Related Mortality ◽

White Patients

Background Aortic stenosis–related mortality might vary across demographic subsets, regions, and states in the United States. Methods and Results We reviewed the death certificate data from the Centers for Disease Control and Prevention Wide‐Ranging OnLine Data for Epidemiologic Research database to examine aortic stenosis–related mortality trends from 2008 to 2018. Crude and age‐adjusted mortality rates (AAMRs) per 100 000 people and annual percentage change with 95% CIs were calculated. Between 2008 and 2018, AAMR reduced from 12.7 to 11.5 (average annual percentage change, −1.0 [95% CI, −1.5 to −0.5]), because of an accelerated decline between 2015 and 2018 (annual percentage change, −4.4 [95% CI, −6.0 to −2.7]). Older (aged >85 years), male, and White patients had higher death rates than younger, female, and non‐White patients, respectively. Although mortality reduction was similar across sexes, significant mortality reduction was limited to White patients only. The AAMRs were higher in rural than urban areas. States with AAMRs >90th percentile were distributed in the West and the Northeast, and <10th percentile in the South. The AAMRs for sex and race were highest in the West and lowest in the South. None of the states located in the Midwest showed a significant reduction in mortality. Mortality remained stable for hospital setting and nursing home/long‐term care facility, except that the number of deaths increased at home and hospice facility since 2014. Conclusions The reduction in mortality in patients with aortic stenosis was not consistent among demographic subsets and states. The substantial public health and economic implications call for determination of underlying clinical and socioeconomic factors to narrow the gap.

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Geographic disparity in systemic sclerosis mortality in the United States: 1999–2017

Journal of Scleroderma and Related Disorders ◽

10.1177/2397198319869566 ◽

2019 ◽

pp. 239719831986956

Author(s):

Alicia Rodriguez-Pla ◽

Robert W Simms

Keyword(s):

United States ◽

Systemic Sclerosis ◽

Mortality Rate ◽

Cause Of Death ◽

American Indians ◽

The United States ◽

Mortality Rates ◽

Progressive Decrease ◽

Targeted Interventions ◽

Underlying Cause Of Death

Introduction: Previous studies reported a progressive decrease in the systemic sclerosis mortality rates in the United States from 1959 to 2002. Identification of areas with clusters of higher mortality rates is important to implement targeted interventions. In this study, we aimed to estimate the mortality rates of scleroderma and to analyze its geographic variability at the state level in the United States. Methods: Mortality rates of scleroderma from 1999 to 2017 were obtained from the CDC Wonder Underlying Cause of Death database and its query system, using International Classification of Diseases, Tenth Revision codes. Age-adjusted rates were calculated by state and demographics. A linear regression model was applied to evaluate trends over time. Results: Over the period studied, a total of 24,525 deaths had scleroderma as the underlying cause of death. The age-adjusted mortality rate was 3.962 per million (95% CI: 3.912–4.012), decreasing progressively from 4.679 (95%CI: 4.423–4.934) in 1999 to 2.993 (95% CI: 2.817–3.170) per million in 2017. The age-adjusted mortality rate was 5.885 (95% CI: 5.802–5.967) and 1.651 (95% CI: 1.604–1.698) per million in females and males, respectively. Per races, the highest age-adjusted mortality rate was in Blacks or African Americans, at 5.703 per million (95% CI: 5.521–5.885), followed by American Indians or Alaska Native at 5.047 per million (95% CI: 4.428–5.667). Clusters of states with higher and lower mortality rates were identified. South Dakota had the highest whereas Hawaii had the lowest mortality rate. Conclusion: We found a trend to a progressive decrease in mortality rates of scleroderma during the years of our study. In addition, we found relevant state-by-state variation in mortality with several geographical clusters with higher mortality rates. Further analyses are warranted in order to better understand the factors associated with the observed geographic disparities.

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Faculty Opinions recommendation of Outcomes Associated With Apixaban Use in Patients With End-Stage Kidney Disease and Atrial Fibrillation in the United States.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.733529032.793548809 ◽

2018 ◽

Author(s):

Simonetta Genovesi

Keyword(s):

United States ◽

Atrial Fibrillation ◽

Kidney Disease ◽

The United States ◽

End Stage Kidney Disease ◽

End Stage

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Commercial Fishing as an Occupational Determinant of Opioid Overdoses and Deaths of Despair in Two Massachusetts Fishing Ports, 2000–2014

NEW SOLUTIONS A Journal of Environmental and Occupational Health Policy ◽

10.1177/10482911211023476 ◽

2021 ◽

pp. 104829112110234

Author(s):

Scott Fulmer ◽

Shruti Jain ◽

David Kriebel

Keyword(s):

United States ◽

Cause Of Death ◽

Death Certificate ◽

The United States ◽

Opioid Overdose ◽

Commercial Fishing ◽

Opioid Epidemic ◽

Death Certificate Data ◽

Deaths Of Despair

The opioid epidemic has had disproportionate effects across various sectors of the population, differentially impacting various occupations. Commercial fishing has among the highest rates of occupational fatalities in the United States. This study used death certificate data from two Massachusetts fishing ports to calculate proportionate mortality ratios of fatal opioid overdose as a cause of death in commercial fishing. Statistically significant proportionate mortality ratios revealed that commercial fishermen were greater than four times more likely to die from opioid poisoning than nonfishermen living in the same fishing ports. These important quantitative findings suggest opioid overdoses, and deaths to diseases of despair in general, deserve further study in prevention, particularly among those employed in commercial fishing.

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