Trends and Disparities in Acute Myocardial Infarction and Type 2 Diabetes Mellitus-Related Mortality in the United States from 1999-2022

BACKGROUND AND AIMS: Acute myocardial infarction (AMI) and type 2 diabetes mellitus (T2DM) are leading causes of mortality, with significant demographic and regional disparities. This study examined mortality trends related to AMI and T2DM among U.S. adults aged ≥25 years from 1999 to 2022. METHODS AND RESULTS: Using the CDC WONDER database, we analyzed death certificates where AMI (ICD-10: I21, I22) and T2DM (ICD-10: E11) were listed as underlying or contributing causes. Age-adjusted mortality rates (AAMRs) per 100,000 population and annual percent change (APC) were calculated and stratified by year, sex, race/ethnicity, and region. Between 1999 and 2022, 196,326 deaths were recorded. AAMRs increased from 3.35 in 1999 to 3.66 in 2003 (APC: 2.39; 95 % CI, -0.69-8.71; p = 0.14), declined to 3.08 in 2014 (APC: -1.75∗; 95 % CI, -4.66 to -0.51; p = 0.05), then significantly rose to 4.64 in 2022 (APC: 6.19∗; 95 % CI, 4.89-7.78; p = 0.002). Men had consistently higher AAMRs than women, rising from 4.30 vs. 2.67 in 1999 to 6.42 vs. 3.18 in 2022. Hispanics had the highest AAMR, followed by non-Hispanic (NH) Black, NH Other, and NH White populations. Regionally, the highest mortality rates were observed in West Virginia and non-metropolitan areas. CONCLUSION: Mortality rates associated with AMI and T2DM have demonstrated an upward trajectory from 2014 to 2022. Notable geographic and demographic disparities remain evident, underscoring the critical need for further research and the implementation of targeted health policy interventions to mitigate these inequalities.