The following is a summary of “Trends in Cardiogenic Shock-Related Mortality in Patients With Acute Myocardial Infarction in the United States, 1999 to 2019,” published in the August 2023 issue of the Cardiovascular Disease by Zuin et al.
A limited amount of data is available regarding mortality trends in patients diagnosed with acute myocardial infarction (AMI) accompanied by cardiogenic shock (CS). This study sought to evaluate the patterns in mortality related to CS-AMI (Cardiogenic Shock Acute Myocardial Infarction) among individuals in the United States (US) during the most recent 21-year period. The mortality data of individuals in the United States who had an acute myocardial infarction (AMI) listed as the primary cause of death and cardiogenic shock (CS) as a contributing factor were collected from the Centers for Disease Control and Prevention WONDER (Wide-Ranging Online Data for Epidemiologic Research) dataset spanning from January 1999 to December 2019. The age-adjusted mortality rates (AAMRs) per 100,000 US population were stratified by gender, race and ethnicity, geographic areas, and urbanicity concerning Cardiovascular System Acute Myocardial Infarction (CS-AMI).
Nationwide annual trends were evaluated using yearly percent change (APC) and average APC with relative 95% CIs in a medical context. From 1999 to 2019, Cardiovascular Systems Acute Myocardial Infarction (CS-AMI) was recorded as the primary factor leading to the demise of 209,642 individuals, with an Age-Adjusted Mortality Rate (AAMR) of 3.01 per 100,000 population (95% CI 2.99 to 3.02). The age-adjusted mortality rate (AAMR) from cardiovascular disease (CS-AMI) exhibited a consistent pattern from 1999 to 2007, with no significant changes observed (annual percent change [APC] −0.2%, 95% CI −2.0 to 0.5, P = 0.22).
However, starting from that point, there was a notable and statistically significant increase in the AAMR (APC 3.1%, 95% CI 2.6 to 3.6, P <0.0001), particularly among male patients. Commencing in 2009, the AAMR (Age-Adjusted Mortality Rate) exhibited a more notable escalation among individuals below 65, Black Americans, and individuals residing in rural regions. The elevated age-adjusted mortality rates (AAMRs) were concentrated in the southern part (mean annual percent change [APC] 4.5%, [95% CI 4.4 to 4.6]) of the nation. In summary, the mortality rate associated with CS-AMI in patients within the United States exhibited an upward trend between 2009 and 2019. Targeted medical policy measures are required to tackle the increasing burden of CS-AMI in individuals residing in the United States.
Source: sciencedirect.com/science/article/abs/pii/S0002914923003107
