Abstract 13624: Worrisome Atrial Fibrillation-Related Mortality Trends in Older Adults From 1999-2019

Abstract

Introduction: The U.S. population is aging with concurrent increases in atrial fibrillation (AF) burden. However, AF-related mortality trends among adult’s ≥75 years have not been investigated. The purpose of this study was to assess the trends and regional differences in AF-related mortality among older adults in the United States. Methods: Death certificates from the CDC WONDER (Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research) database were examined from 1999 to 2019 for AF-related mortality in adult’s ≥75 years of age. Age-adjusted mortality rates (AAMRs) per 100,000 persons was calculated and stratified by year, sex, race/ethnicity, and geographic region. Results: Between 1999 and 2019, 323,349 AF-related primary deaths occurred among adult’s ≥75 years. The AAMR more than doubled from 44.8 (95% CI, 43.8 to 45.8) in 1999 to 91.7 in 2019 (95% CI: 87.2 to 89.6)). Women had consistently higher AAMR than men from 1999 (AAMR women: 45.8 vs men: 42.3) to 2019 (AAMR women: 93.2 vs men: 88.4). White adults had the highest overall AAMR (77.5), followed by NH American Indian/Alaska Native (41.6), NH Black (41.3) and NH Asian or Pacific Islander adults (36.6). AAMR also varied substantially by region (overall AAMR: Midwest 77.6; West: 75.0; Northeast: 71.6; and South: 69.7). States in the top 90th percentile of AF-related AAMR were Oregon, Idaho and Utah, which had approximately double the AAMRs compared with states that fell into the lower 10th percentile such as South Dakota and Florida. Conclusions: AF-related mortality in U.S. adult’s ≥75 years has continuously increased since 1999. The highest AAMRs were observed among White adults and women, and among patients living in the Midwest and western regions of the United States. Targeted strategies are needed to prevent and treat AF among older adults to curb increasing levels of AF-related mortality.