Abstract 562: Ischemic Heart Disease Mortality And Systemic Lupus Erythematosus

Abstract

Introduction: Systematic lupus erythematosus (SLE) is associated with significant morbidity and mortality, contributing to accelerated atherosclerotic disease. We sought to quantify ischemic heart disease (IHD) mortality trends in individuals with SLE in the United States (U.S.). Hypothesis: Disparities related to IHD mortality in individuals with SLE exist. Methods: Cross-sectional analyses were conducted using the CDC Wide-ranging Online Data for Epidemiologic Research database to capture all mortality data in the U.S. using death certificate information from 1999 to 2020. We identified individuals with IHD (ICD10: I20-I25) as the underlying cause of death and SLE (ICD10: M32) as the multiple causes of death. Underlying cause of death was defined as the diagnosis that led to mortality and multiple causes of death were defined as the diagnoses that contributed to mortality. Quantified measures included age-adjusted mortality rate (AAMR) per 100,000 population and corresponding 95% confidence intervals. AAMR was adjusted to the U.S. population in the year 2000. Results: We identified 2,733 deaths from 1999 to 2020. AAMR decreased from 0.055 (95% CI, 0.046 - 0.064) in 1999 to 0.027 (95% CI, 0.023 - 0.032) in 2020. Females were disproportionately affected by higher AAMR compared to males (0.054 [95% CI, 0.051 - 0.056] and 0.013 [95% CI, 0.011 - 0.014], respectively). Black populations had the highest AAMR (0.084 [95% CI, 0.077 - 0.090]), with no significant differences among other racial groups such as White (0.029 [95% CI, 0.028 - 0.030], American Indian/Alaska Native (0.041 [95% CI, 0.025 - 0.063]), and Asian/Pacific Islander (0.023 [95% CI, 0.017 - 0.030]) populations. No differences in AAMR were observed between metropolitan and non-metropolitan regions (0.027 [95% CI, 0.026 - 0.029] and 0.029 [95% CI, 0.026 - 0.032], respectively). The West had the highest AAMR (0.036 [95% CI, 0.033 - 0.039]), with no significant differences among the Northeastern (0.027 [95% CI, 0.024 - 0.030]), Midwestern (0.027 [95% CI, 0.025 - 0.030]), and Southern regions (0.029 [95% CI, 0.027 - 0.031]). Conclusion: IHD mortality in individuals with SLE remains disproportionately concentrated in females, Black populations, and Western regions.