Mortality for coexisting pulmonary hypertension and atrial fibrillation increased from 1999 to 2020, with an average annual percentage change of 10.51% in females and 11.65% in males (p<0.001).
Observational (n=50,000)
Yes
There has been a significant and steady increase in mortality associated with coexisting pulmonary hypertension and atrial fibrillation in the US from 1999 to 2020, highlighting the need for improved management of these concurrent conditions.
Effect estimate: AAPC 10.51% (females), 11.65% (males)
p-value: p=<0.001
Abstract Introduction The association between Pulmonary hypertension (PH) and atrial fibrillation (AF) remains unexplored, though it frequently coexists. This study aimed to analyze mortality trends and demographic disparities in AF with PH using the CDC Wide-Ranging Online Data for Epidemiologic Research (CDC-WONDER) Multiple Causes of Death (MCD) database from 1999 to 2020. Methodology We analyzed MCD data from the CDC-WONDER database (1999-2020), identifying deaths in which both PH (ICD-10:I27 and I27.2) and atrial fibrillation/flutter(ICD-10:I48) were listed. Data were analyzed by urbanization, gender, race, geographic region, and place of death. Age-adjusted mortality rates (AAMR) and annual percentage change (APC) were calculated using statistical analysis, JointPoint regression software. Results There were over 50,000 deaths involving both PH and AF in the United States (US). The adjusted mortality rates increased in both females and males from 0.197 in 1999 to 1.707 in 2020, and from 0.179 in 1999 to 1.628 in 2020, respectively. The average annual percentage change (AAPC) in females and males from 1999 to 2020 was 10.51% and 11.65%, respectively; both were statistically significant (p 0.001). In females, the APC from 1999-2009, 2009-2016, and 2016-2020 were 12.987%, 7.186%, and 10.321%, respectively. For males, APC from 1999-2010, 2010-2017, and 2017-2020 were 13.02%, 8.73%, and 13.559%, respectively. The highest number of deaths occurred in inpatient settings, followed by the deceased’s home and nursing or long-term care facilities. There was a steady rise in AAPC among Black/African Americans, with APC at 9.17% per year, 95% CI 8.48-9.87, p 0.001. However, there were three distinct phases of mortality increase among white individuals, with an AAPC from 1999-2020 of 10.97%, 95% CI 10.47-11.47, p 0.001. Age-adjusted rates were highest in Colorado, Vermont, and Oregon, and lowest in Louisiana. For metropolitan and non-metropolitan areas, age-adjusted rates from 1999 to 2020 ranged from 0.157 to 2.039 and 0.175 to 1.86, respectively. Conclusion Over two decades, mortality involving PH and AF increased with disparities involving sex, race, urban areas, and region. There are also increasing proportions of deaths occurring outside the inpatient settings at descendants’ homes, highlighting the need to study that population in detail. This underscores the importance of screening measures, management of both conditions, and increasing access to underserved areas. This abstract is funded by: None
Bhatt et al. (Fri,) conducted a observational in Pulmonary hypertension and atrial fibrillation (n=50,000). Observation of mortality trends was evaluated on Age-adjusted mortality rates and annual percentage change (AAPC 10.51% (females), 11.65% (males), p=<0.001). Mortality for coexisting pulmonary hypertension and atrial fibrillation increased from 1999 to 2020, with an average annual percentage change of 10.51% in females and 11.65% in males (p<0.001).
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