F-57 | Temporal Trends in Mortality From Acute Myocardial Infarction With Concomitant Aortic Stenosis in the United States

Background: Acute myocardial infarction (AMI) and aortic stenosis (AS) frequently coexist in older adults and may confer particularly high mortality, yet contemporary, sex-specific population trends in joint AMI-AS deaths are not well defined.Understanding these trends may inform prevention, structural heart interventions, and post-AMI care pathways in patients with valvular disease.Methods: Mortality data were obtained from the US Multiple Cause of Death files (1999-2023) for decedents aged 25 years with AMI (ICD-10 I21.x) and AS (I35.0) both listed as causes of death, stratified by sex.Age-adjusted mortality rates per 100,000 population were calculated using the 2000 US standard population, and temporal trends were modeled with log-linear joinpoint regression to estimate average annual percent change (AAPC).Results: Over 1999-2023, age-adjusted AMI+AS mortality declined from 1.09 to 0.54 per 100,000 in women and from 1.62 to 0.99 per 100,000 in men.Joinpoint regression identified a constant downward trajectory with AAPC -2.76% in females and -2.06% in males (both p<0.05), with absolute rates remaining higher in men and residual burden concentrated in those 75 years.Conclusions: Mortality in which AMI and AS co-occur on the death certificate has fallen steadily for more than two decades in both sexes, with a steeper relative decline in women.These findings suggest that advances in AMI management, valve therapies, and risk-factor control have translated into population-level mortality gains, but older adults, particularly men, remain a high-risk group requiring targeted preventive and structural heart-disease strategies.