What is the clinical evidence from this study?

Study design: Observational. Population: Sudden cardiac death in adults with coronary artery disease (n=149813). Primary outcome: Age-adjusted mortality rates (AAMRs) for SCD-CAD (AAPC -3.59%, 95% CI -4.07 to -3.39).

What question did this study set out to answer?

This analysis aims to explore national trends and demographic disparities in sudden cardiac death mortality among adults with coronary artery disease.

April 26, 2026Open Access

D-42 | Trends and Outcomes in Sudden Cardiac Death Mortality Among Adults With Coronary Artery Disease (1999-2024): A Nationwide Analysis

Key Result

SCD mortality among adults with CAD declined significantly from 1999 to 2024 (AAPC -3.59%; 95% CI -4.07 to -3.39), with persistent disparities by sex, race, region, and urbanization.

Key Points

This analysis aims to explore national trends and demographic disparities in sudden cardiac death mortality among adults with coronary artery disease.
Analyzed CDC WONDER data from 1999-2024 for adults aged 25 years and older with SCD and CAD.
Calculated age-adjusted mortality rates stratified by sex, race/ethnicity, region, and urban/rural status.
Used joinpoint regression to estimate average annual percent changes in mortality rates.
Overall age-adjusted mortality rate for SCD-CAD declined from 3.8 in 1999 to 1.6 in 2024 (AAPC: -3.59%, 95% CI: -4.07 to -3.39).
Men exhibited higher mortality rates (4.0) than women (1.6), and NH Black adults had the highest rates (3.0, 95% CI: 2.7-3.2).
Rural areas demonstrated higher mortality rates (4.8) compared to urban areas (2.3).

Study Design

Type

Observational (n=149,813)

Multicenter

Yes

Structured PICO

Population

149,813 U.S. decedents aged ≥25 years with sudden cardiac death (SCD) and coronary artery disease (CAD) from 1999-2024.

Outcome

Age-adjusted mortality rates (AAMRs) and average annual percent changes (AAPC) in SCD-CAD mortalityhard clinical

SCD mortality in adults with CAD has declined significantly in the US from 1999 to 2024, though significant demographic and regional disparities persist.

Main Result

Effect estimate: AAPC -3.59% (95% CI -4.07 to -3.39)

Abstract

Background: Sudden cardiac death (SCD) is a leading cause of mortality in adults with coronary artery disease (CAD), yet national trends and demographic disparities in CAD-related SCD remain underexplored.Methods: We analyzed CDC WONDER data (1999-2024) for U.S. decedents aged 25 years with SCD (ICD-10: I46) and CAD (ICD-10: I25).Age-adjusted mortality rates (AAMRs) were calculated and stratified by sex, race/ethnicity, region, and urban/rural status.Joinpoint regression was used to estimate average annual percent changes (AAPC) in AAMR.Results: From 1999-2024, there were 149,813 SCD-CAD deaths.The overall AAMR declined from 3.8 in 1999 to 1.6 in 2024 (AAPC: -3.59%, 95% CI: -4.07 to -3.39).Men had higher AAMRs (4.0) than women (1.6).Non-Hispanic (NH) Black adults had the highest AAMR (3.0, 95% CI: 2.7-3.2),followed by NH White (2.8, 95% CI: 2.7-2.9),Hispanic (1.2, 95% CI: 1.0-1.4),and NH Other (1.1, 95% CI: 0.9-1.4).Regionally, the South had the highest AAMR (3.1), followed by the Midwest (3.0), Northeast (2.2), and West (1.8).Rural areas had higher AAMRs than urban areas (4.8 vs. 2.3).Conclusions: SCD mortality among adults with CAD declined significantly from 1999-2018, increased slightly in 2018-2021, and dropped steeply through 2024.Persistent disparities by sex, race, region, and urbanization highlight the need for targeted prevention and community-based interventions.

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