A-44 | Temporal trends and disparities in Acute Myocardial Infarction mortality: A comprehensive Analysis (1999-2020) in the United States

Acute myocardial infarction (AMI) remains a significant cause of morbidity and mortality worldwide. Over the years, advancements in medical care and interventions have impacted the outcomes of patients with AMI. However, there may be evolving trends and disparities that necessitate detailed examination. We conducted a retrospective cohort analysis using the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database, looking at underlying cause of death (UCOD) with AMI (ICD10 code: I21) in the United States (US), from year 1999 to 2020. A total of 2,780,068 deaths were documented as UCOD attributed to AMI in the US between the years 1999 and 2020. Of these 45.5% were women and 54.6% were men. The age-adjusted mortality rate (AAMR) related to AMI significantly decreased from 11.57 per million population (95% CI 11.52 to 11.62) in 1999 to 4.26 (95% CI: 4.23 to 4.29) in 2020. Non-Hispanic Blacks (NHB) consistently experienced higher mortality rates compared to Non-Hispanic Whites (NHW) across all age groups, except for individuals aged 85 and above, where the crude mortality rate increased in NHW population. The 85+ age group had the highest crude mortality rate, reaching 78.05 per million population (95% CI: 77.89 to 78.22). Throughout the study period, the AAMR decreased steadily across all Health and Human Services (HHS) regions. HHS 1 had the most substantial decline (71%), while HHS 7 (59.4%) had the smallest decline. This study reveals a positive trend in AMI outcomes with an overall decline in mortality. Despite this reduction in AAMR, disparities in mortality rates persist, particularly among NHB, underscoring the urgent need for targeted interventions and healthcare initiatives to address this inequality. Additionally, regional analyses highlight that HHS 7 has experienced the smallest decline in AMI-associated mortality, emphasizing the importance of tailoring healthcare strategies to specific regions. In summary, our study offers crucial insights that can guide public health policies, medical interventions, and future research initiatives, aiming to further improve AMI outcomes and mitigate disparities.