Comparison of mortality trends in patients with rheumatic mitral valve disease and nonrheumatic mitral valve disease: A retrospective study in US from 1999 to 2020

Abstract

Background: Mitral valve disease (MVD) can have both rheumatic and nonrheumatic etiologies. However, differences in mortality remain unknown. Methods: We extracted age-adjusted mortality rates (AAMRs) per 100,000 persons from the CDC WONDER database and stratified them by sex, region, and race. Annual percent change (APC) and average annual percent change (AAPC) were calculated using Joinpoint regression. Pairwise comparison was used to identify significant differences for MVD mortality trends between rheumatic and nonrheumatic patients. Results: From 1999 to 2020, a total of 72,085 deaths were recorded in patients with rheumatic MVD, while 132,300 occurred in those with nonrheumatic MVD. The AAMR for nonrheumatic patients was twice as high as that for rheumatic patients throughout the study period, and AAPC differed significantly between the groups (p < 0.05). Females with rheumatic MVD were observed to have a higher AAMR (1.1) than their male counterparts (0.8), but those with nonrheumatic MVD exhibited a similar AAMR for both females and males. Among rheumatic patients, NH (non-hispanic) Whites were reported to have the highest AAMR (1.0), followed by NH Black or African Americans (0.8), Hispanic or Latinos (0.7), and NH Asian or Pacific Islanders (0.7). Among nonrheumatic patients, NH Whites exhibited the highest AAMR (1.9), followed by NH Black or African Americans (1.4), NH Asian or Pacific Islanders (1.1), and Hispanic or Latinos (1.0). The AAMR in Rural areas was higher than that in Urban areas for patients with both rheumatic and nonrheumatic MVD. Conclusion: Comprehensive public health strategies are essential to improving survival outcomes.