Abstract WP110: Acute Myocardial Infarction-Related Mortality Trends In Stroke Patients In The US From 1999-2023: Insights From CDC WONDER

BACKGROUND: AMI and stroke remain leading causes of death in the United States. There is a two to threefold increased risk of adverse cardiovascular events like AMI in stroke patients, which increases mortality by 40% in this population. Both conditions share risk factors and worsen the prognosis of each other. Although advances in acute care and secondary prevention have improved outcomes, racial, sex-based, and regional disparities persist across the United States. In this study, we analyze long-term national trends in AMI-related mortality among stroke patients in the U.S. aged ≥ 25 years from 1999 to 2023. METHODS: We analyzed mortality due to AMI (ICD-10 code: I21) in patients with 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 Annual Percent Change (APC) and Average Annual Percent Change (AAPC). RESULTS: A total of 161,600 deaths from Acute MI in stroke patients were identified. The overall AAMR decreased significantly from 7.0 in 1999 to 1.56 in 2023 (AAPC: -5.98; 95% CI: -6.74 to -5.21; p<0.000001), with the sharpest decline observed between 2003 and 2007 (APC: -13.41; 95% CI: -16.43 to -10.27; p=0.000001). Older stroke patients aged 65 and above had the highest mortality burden among all age groups (140,389 deaths and average AAMR: 14.03). Males recorded higher AAMR than women (3.7 vs 2.66). Non-Hispanic (NH) Black Americans had the highest AAMR (4.73), followed by NH White (2.97), NH Asians (2.71) and Hispanic individuals (2.63). Metropolitan areas had slightly higher AAMR than non-metropolitan areas (2.91 vs 2.5), while among the census regions the South had the highest AAMR (3.3) and the Northeast had the lowest AAMR (2.7). CONCLUSION: The AAMRs have decreased significantly, possibly due to better prevention of risk factors, increased acute care and improvements in public health policy. An increased sharp rise in the total number of deaths after 2020 highlights the continuous burden and the necessity for focused prevention and reestablishment of care post-pandemic. Higher rates in older adults, men, non-Hispanic Black Americans, and those in southern, metropolitan areas reflect ongoing health disparities and systemic inequities. Public health efforts must be directed towards addressing these increasing inequalities.