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February 6, 2026European Heart Journal0 citations

Changing trends in myocardial infarction mortality among young adults in the United States: a 25-year analysis of disparities and the COVID-19 impact

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AMAhmad MesmarRARawan AbukhaterWAW Abdalla

Key Result

MI-related mortality among US young adults declined from an AAMR of 3.8 in 1999 to 2.3 in 2023, with a temporary increase during the COVID-19 pandemic and persistently higher rates in men.

Key Points

  • The study aims to analyze trends in myocardial infarction mortality among young adults in the United States over 25 years.
  • Analyzed death certificates from the CDC WONDER database (1999–2023)
  • Identified myocardial infarction-related mortality rates
  • Reported age-adjusted mortality rates (AAMRs) and annual percentage changes (APCs)
  • 91,482 deaths attributed to myocardial infarction among young adults (1999-2023)
  • AAMRs declined from 3.8 (1999) to 2.5 (2018) before rising to 3.2 by 2021 due to COVID-19
  • Men had higher AAMRs (average 4.5) compared to women (1.8)
  • Non-Hispanic Black individuals had the highest AAMR at 5, while rural areas had higher rates than urban areas (6.4 vs. 2.6)

Study Design

Type

Observational (n=91,482)

Multicenter

Yes

Structured PICO

P
Population
91,482 MI-related deaths among young adults (15-44 years) in the US from 1999 to 2023.
O
Outcome
MI-related mortality, reported as age-adjusted mortality rates (AAMRs) per 100,000 people and annual percentage changes (APCs)hard clinical

MI mortality in young US adults has generally declined over the past 25 years, despite a temporary increase during the COVID-19 pandemic, though significant demographic and geographic disparities persist.

Abstract

Abstract Background Myocardial infarction (MI) generally occurs among old individuals. However, changing dietary patterns, stress, and smoking have led to an increased risk of MI among young adults. This study aims to analyze 25-year MI-mortality-related trends among young adults (15-44 years) in the US. Methods The death certificates from the CDC WONDER database (1999–2023) were analyzed to identify MI-related mortality, reporting age-adjusted mortality rates (AAMRs) per 100,000 people, and annual percentage changes (APCs). Results A total of 91,482 deaths were attributed to MI among young adults in the US from 1999 to 2023. The AAMRs declined from 3.8 in 1999 to 2.5 in 2018, followed by an increase to 3.2 by 2021 (APC: 8.1), coinciding with the COVID-19 pandemic. This was followed by a decline to an AAMR of 2.3 in 2023. Men had consistently higher AAMR compared to women throughout the study period (average AAMR: 4.5 vs. 1.8). Among racial/ethnic groups, the highest AAMR was observed in the non-Hispanic (NH) Black or African American individuals (5), followed by the NH White (3.2), Hispanic or Latino (1.5), and NH Other populations (1.3) in 2023. The southern region had the highest AAMR when stratified by census regions and rural areas had higher mortality rates than urban areas (6.4 vs. 2.6). Conclusion From 1999-2023, MI-related mortality among young adults in the US showed an overall decline, with a temporary increase during the COVID-19 pandemic. Men, NH Black individuals, and those in rural or southern regions had consistently higher mortality rates. These findings highlight persistent disparities in MI-related mortality across demographic and geographic groups.Overall and sex stratified AAMR Race stratified AAMR

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Cite This Study

Mesmar et al. (2025) conducted an observational in Myocardial infarction (n=91,482). Demographic and geographic factors over time was evaluated on MI-related age-adjusted mortality rates (AAMRs) per 100,000 people. MI-related mortality among US young adults declined from an AAMR of 3.8 in 1999 to 2.3 in 2023, with a temporary increase during the COVID-19 pandemic and persistently higher rates in men.

synapsesocial.com/papers/698585758f7c464f23008cc6https://doi.org/10.1093/eurheartj/ehaf784.3436
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