Temporal trends and disparities in cardiac arrest and co-listed acute myocardial infarction-related mortality in the United States, 1999–2025: Insights from CDC WONDER database

Q: What are the key findings of this study?

Age-adjusted mortality rates for cardiac arrest with co-listed acute myocardial infarction declined from 22.06 in 1999 to 7.37 in 2025 (AAPC -4.28%, p≤0.001), with persistent disparities.

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Cardiac arrest and co-listed acute myocardial infarction (n=747073). Intervention: Co-listed cardiac arrest and acute myocardial infarction vs. Demographic, geographic, and temporal subgroups (1999 vs 2025). Primary outcome: Age-adjusted mortality rate (AAMR) per 100,000 population for deaths with co-listed cardiac arrest and acute myocardial infarction from 1999 to 2025 (AAPC -4.28%, 95% CI -4.57 to -4.10, p=≤0.001).

Q: What does this research mean for the field?

Age-adjusted mortality rates for cardiac arrest with co-listed acute myocardial infarction in the United States decreased substantially between 1999 and 2025, while persistent demographic and geographic disparities remained. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

FNU Arsheen; Syeda Samia Fatima; Muhammad Shaheer; Areeba Asif; Aliza Fatima; Muneeb Fareed; Abdur Rafay Farooq; Nisha Khalid; Asma Naz; Hina Safeer; Saifullah Khan; Hasibullah Aminpoor

doi:10.1038/s41598-026-75193-w

November 4, 2026Scientific ReportsOpen Access

Temporal trends and disparities in cardiac arrest and co-listed acute myocardial infarction-related mortality in the United States, 1999–2025: Insights from CDC WONDER database

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Key result

Mortality for cardiac arrest with AMI drops ~4% annually from 1999 to 2025.

AAPC -4.28%
95% CI -4.57 to -4.10
P≤0.001
n=747,073

Why the study?

Cardiac arrest and acute myocardial infarction are closely linked major contributors to mortality, motivating an evaluation of national mortality trends and demographic and geographic disparities in cardiac arrest co-listed with acute myocardial infarction in the United States.

Key Points

To evaluate national trends and demographic and geographic disparities in mortality associated with cardiac arrest co-listed with acute myocardial infarction among United States adults from 1999 to 2025.
Retrospective analysis of national death certificate data from the CDC WONDER Multiple Cause of Death database from 1999 to 2025 for adults aged ≥ 25 years (N=747,073 deaths).
Overall AAMR decreased from 22.06 in 1999 to 7.37 in 2025 (AAPC: −4.28; 95% CI: −4.57 to −4.10; p ≤ 0.000001).
Men had higher mean AAMRs than women (16.38 vs. 9.77), and mortality was highest among older adults aged ≥ 65 years (mean AAMR: 51.35).
Non-Hispanic Black individuals had the highest mean AAMR (17.14), while geographically the Northeast had the highest mean AAMR (16.29) and rural areas showed slightly higher rates than urban areas (14.29 vs. 13.53).

Study Design

Type

Observational (n=747,073)

Multicenter

Yes

Structured PICO

P

Population

747,073 U.S. adult decedents aged ≥25 years with co-listed cardiac arrest and acute myocardial infarction on death certificates recorded in the CDC WONDER database between 1999 and 2025.

O

Outcome

Age-adjusted mortality rates (AAMRs) per 100,000 population and annual average percentage changes (AAPCs) for death records with co-listed cardiac arrest and acute myocardial infarction from 1999 to 2025.hard clinical

Main Result

Effect estimate: AAPC -4.28% (95% CI -4.57 to -4.10)

Absolute Event Rate: 7.37% vs 22.06%

p-value: p=≤0.001

U.S. mortality associated with co-listed cardiac arrest and acute myocardial infarction declined substantially between 1999 and 2025, but significant disparities persist among men, Non-Hispanic Black individuals, older adults, and rural residents.

Limitations

Reliance on ICD-10 codes on death certificates, which may be subject to misclassification or misinterpretation.
Co-listing of cardiac arrest and acute myocardial infarction on a death certificate does not establish a temporal or causal relationship between the conditions.
Lack of detailed patient-level clinical, laboratory, socioeconomic, and treatment information in the CDC WONDER database.
Urbanization stratification data were only available through 2020, limiting urban-rural trend analysis across the full 1999–2025 period.
2025 mortality data were provisional at the time of extraction.
Co-listing on death certificates does not establish a temporal or causal relationship between AMI and CA or confirm that either was the underlying cause of death.
Data for the year 2025 were provisional at the time of extraction.
Ecological nature of the data does not allow establishment of direct causal links (e.g., regarding the impact of the COVID-19 pandemic).
CDC WONDER database only contains aggregate mortality information, precluding analysis of individual-level clinical variables, access to care, or specific treatment strategies.
Records with suppressed counts (<10 deaths) or deemed unreliable were excluded from the analysis.

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Implication

Declining mortality rates may reflect care advances; leaves open targeted research to resolve persistent sex, racial, and geographic disparities.

Abstract

Cardiac Arrest (CA) and Acute Myocardial Infarction (AMI) are closely linked cardiovascular conditions and major contributors to global mortality. We evaluated national trends in mortality associated with CA co-listed with AMI among United States (U.S) adults from 1999 to 2025 and assessed demographic and geographic disparities. Using CDC WONDER Multiple Cause of Death, we conducted a retrospective analysis of CA and co-listed AMI-related mortality from 1999 to 2025 among adults aged ≥ 25 years. Age-adjusted mortality rates (AAMRs) were calculated, and joinpoint regression was utilized to estimate annual average percentage changes (AAPCs) with 95% confidence intervals (CIs). There were 747,073 reported deaths due to CA and co-listed AMI. The AAMR decreased from 22.06 in 1999 to 7.37 in 2025 (AAPC: −4.28; p ≤ 0.000001). Men had higher mean AAMRs than women (mean AAMR: men 16.38; women: 9.77). Among races, Non-Hispanic (NH) Black individuals had the highest mean AAMR (17.14). Mortality burden was greatest among older adults aged ≥ 65 years (mean AAMR: 51.35). Regionally, the Northeast had the highest mean AAMR (16.29), and rural areas showed slightly higher mortality compared with urban areas (14.29 vs. 13.53). Most deaths (69.22%) occurred in medical facilities. Mortality associated with CA and co-listed AMI has declined substantially in the U.S over the past two decades, with significant disparities. These findings highlight the importance of improved risk stratification and targeted preventive strategies in high-risk populations.

Discussion

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Cite This Study

Arsheen et al. (2026) conducted an observational in Cardiac arrest and co-listed acute myocardial infarction (n=747,073). Co-listed cardiac arrest and acute myocardial infarction vs. Demographic, geographic, and temporal subgroups (1999 vs 2025) was evaluated on Age-adjusted mortality rate (AAMR) per 100,000 population for deaths with co-listed cardiac arrest and acute myocardial infarction from 1999 to 2025 (AAPC -4.28%, 95% CI -4.57 to -4.10, p=≤0.001). Age-adjusted mortality rates for cardiac arrest with co-listed acute myocardial infarction declined from 22.06 in 1999 to 7.37 in 2025 (AAPC -4.28%, p≤0.001), with persistent disparities.

synapsesocial.com/papers/6aed6e573dd5ffb8e184d021 https://doi.org/10.1038/s41598-026-75193-w

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Temporal trends and disparities in cardiac arrest and co-listed acute myocardial infarction-related mortality in the United States, 1999–2025: Insights from CDC WONDER database

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Temporal trends and disparities in cardiac arrest and co-listed acute myocardial infarction-related mortality in the United States, 1999–2025: Insights from CDC WONDER database

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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