Muhammad Abdullah Naveed, Ahila Ali, Sivaram Neppala, Faizan Ahmed, Palak Patel, Bazil Azeem, Muhammad Omer Rehan, Rabia Iqbal, Manahil Mubeen, Ayman Fath, Timir Paul
{"title":"成人糖尿病患者冠心病死亡率趋势：来自美国疾病预防控制中心 WONDER（1999-2020 年）的启示。","authors":"Muhammad Abdullah Naveed, Ahila Ali, Sivaram Neppala, Faizan Ahmed, Palak Patel, Bazil Azeem, Muhammad Omer Rehan, Rabia Iqbal, Manahil Mubeen, Ayman Fath, Timir Paul","doi":"10.1016/j.carrev.2024.11.002","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Coronary artery disease (CAD) in diabetes mellitus (DM) is a significant cause of mortality among US adults. This study investigates trends in CAD-related mortality in adults aged 25 and older with DM, focusing on geographic, gender, and racial/ethnic disparities from 1999 to 2020.</p><p><strong>Methods: </strong>A retrospective analysis was conducted using death certificate data from the CDC WONDER database from 1999 to 2020. Age-adjusted mortality rates (AAMRs), annual percent change (APC), and average annual percentage change (AAPC) were calculated per 100,000 persons, stratified by year, sex, race/ethnicity, and geographical region.</p><p><strong>Results: </strong>CAD in DM accounted for 1,462,279 deaths among US adults aged 25+. Most deaths occurred in medical facilities (44.2 %) and at home (29.3 %). The overall AAMR for CAD in DM-related deaths decreased from 36.3 in 1999 to 31.7 in 2020, with an AAPC of -0.96 (95 % CI: -1.29 to -0.77, p < 0.000001). Men had higher AAMRs (41.6) compared to women (22.6), with a more significant decrease in women (AAPC: -2.10, p < 0.000001) than in men (AAPC: -0.34, p = 0.001200). Racial/ethnic disparities showed the highest AAMRs in American Indians/Alaska Natives (43.6), followed by Blacks (37.8), Hispanics (33.8), Whites (29.7), and Asians/Pacific Islanders (22.5). The most significant decrease was in Hispanics (AAPC: -1.64, p < 0.000001). Geographically, AAMRs ranged from 13.7 in Nevada to 51.3 in West Virginia, with the highest mortality observed in the Midwest (AAMR: 34.5). Nonmetropolitan areas exhibited higher AAMRs (35.2) than metropolitan areas (29.7), with a more pronounced decrease in metropolitan areas (AAPC: -1.22, p < 0.000001) compared to nonmetropolitan areas (AAPC: -0.03, p = 0.854629).</p><p><strong>Conclusion: </strong>The notable increase in mortality rates associated with CAD among patients with DM from 2018 to 2020 presents a substantial concern that necessitates targeted public health interventions to ensure equitable access to cardiovascular care.</p>","PeriodicalId":47657,"journal":{"name":"Cardiovascular Revascularization Medicine","volume":" ","pages":""},"PeriodicalIF":1.6000,"publicationDate":"2024-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Trends in coronary artery disease mortality among adults with diabetes: Insights from CDC WONDER (1999-2020).\",\"authors\":\"Muhammad Abdullah Naveed, Ahila Ali, Sivaram Neppala, Faizan Ahmed, Palak Patel, Bazil Azeem, Muhammad Omer Rehan, Rabia Iqbal, Manahil Mubeen, Ayman Fath, Timir Paul\",\"doi\":\"10.1016/j.carrev.2024.11.002\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Coronary artery disease (CAD) in diabetes mellitus (DM) is a significant cause of mortality among US adults. This study investigates trends in CAD-related mortality in adults aged 25 and older with DM, focusing on geographic, gender, and racial/ethnic disparities from 1999 to 2020.</p><p><strong>Methods: </strong>A retrospective analysis was conducted using death certificate data from the CDC WONDER database from 1999 to 2020. Age-adjusted mortality rates (AAMRs), annual percent change (APC), and average annual percentage change (AAPC) were calculated per 100,000 persons, stratified by year, sex, race/ethnicity, and geographical region.</p><p><strong>Results: </strong>CAD in DM accounted for 1,462,279 deaths among US adults aged 25+. Most deaths occurred in medical facilities (44.2 %) and at home (29.3 %). The overall AAMR for CAD in DM-related deaths decreased from 36.3 in 1999 to 31.7 in 2020, with an AAPC of -0.96 (95 % CI: -1.29 to -0.77, p < 0.000001). Men had higher AAMRs (41.6) compared to women (22.6), with a more significant decrease in women (AAPC: -2.10, p < 0.000001) than in men (AAPC: -0.34, p = 0.001200). Racial/ethnic disparities showed the highest AAMRs in American Indians/Alaska Natives (43.6), followed by Blacks (37.8), Hispanics (33.8), Whites (29.7), and Asians/Pacific Islanders (22.5). The most significant decrease was in Hispanics (AAPC: -1.64, p < 0.000001). Geographically, AAMRs ranged from 13.7 in Nevada to 51.3 in West Virginia, with the highest mortality observed in the Midwest (AAMR: 34.5). Nonmetropolitan areas exhibited higher AAMRs (35.2) than metropolitan areas (29.7), with a more pronounced decrease in metropolitan areas (AAPC: -1.22, p < 0.000001) compared to nonmetropolitan areas (AAPC: -0.03, p = 0.854629).</p><p><strong>Conclusion: </strong>The notable increase in mortality rates associated with CAD among patients with DM from 2018 to 2020 presents a substantial concern that necessitates targeted public health interventions to ensure equitable access to cardiovascular care.</p>\",\"PeriodicalId\":47657,\"journal\":{\"name\":\"Cardiovascular Revascularization Medicine\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.6000,\"publicationDate\":\"2024-11-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Cardiovascular Revascularization Medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1016/j.carrev.2024.11.002\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cardiovascular Revascularization Medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1016/j.carrev.2024.11.002","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Trends in coronary artery disease mortality among adults with diabetes: Insights from CDC WONDER (1999-2020).
Background: Coronary artery disease (CAD) in diabetes mellitus (DM) is a significant cause of mortality among US adults. This study investigates trends in CAD-related mortality in adults aged 25 and older with DM, focusing on geographic, gender, and racial/ethnic disparities from 1999 to 2020.
Methods: A retrospective analysis was conducted using death certificate data from the CDC WONDER database from 1999 to 2020. Age-adjusted mortality rates (AAMRs), annual percent change (APC), and average annual percentage change (AAPC) were calculated per 100,000 persons, stratified by year, sex, race/ethnicity, and geographical region.
Results: CAD in DM accounted for 1,462,279 deaths among US adults aged 25+. Most deaths occurred in medical facilities (44.2 %) and at home (29.3 %). The overall AAMR for CAD in DM-related deaths decreased from 36.3 in 1999 to 31.7 in 2020, with an AAPC of -0.96 (95 % CI: -1.29 to -0.77, p < 0.000001). Men had higher AAMRs (41.6) compared to women (22.6), with a more significant decrease in women (AAPC: -2.10, p < 0.000001) than in men (AAPC: -0.34, p = 0.001200). Racial/ethnic disparities showed the highest AAMRs in American Indians/Alaska Natives (43.6), followed by Blacks (37.8), Hispanics (33.8), Whites (29.7), and Asians/Pacific Islanders (22.5). The most significant decrease was in Hispanics (AAPC: -1.64, p < 0.000001). Geographically, AAMRs ranged from 13.7 in Nevada to 51.3 in West Virginia, with the highest mortality observed in the Midwest (AAMR: 34.5). Nonmetropolitan areas exhibited higher AAMRs (35.2) than metropolitan areas (29.7), with a more pronounced decrease in metropolitan areas (AAPC: -1.22, p < 0.000001) compared to nonmetropolitan areas (AAPC: -0.03, p = 0.854629).
Conclusion: The notable increase in mortality rates associated with CAD among patients with DM from 2018 to 2020 presents a substantial concern that necessitates targeted public health interventions to ensure equitable access to cardiovascular care.
期刊介绍：
Cardiovascular Revascularization Medicine (CRM) is an international and multidisciplinary journal that publishes original laboratory and clinical investigations related to revascularization therapies in cardiovascular medicine. Cardiovascular Revascularization Medicine publishes articles related to preclinical work and molecular interventions, including angiogenesis, cell therapy, pharmacological interventions, restenosis management, and prevention, including experiments conducted in human subjects, in laboratory animals, and in vitro. Specific areas of interest include percutaneous angioplasty in coronary and peripheral arteries, intervention in structural heart disease, cardiovascular surgery, etc.
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