Sex and racial disparities in proportional mortality of premature myocardial infarction in the USA from 1999-2020

Abstract

Abstract Background The incidence of premature myocardial infarction (PMI) (females <65 years and males <55 years) is increasing. We investigated proportional mortality trends related to PMI stratified by sex, race, and ethnicity from 1999-2020. Methods The CDC WONDER (Center for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research) was queried to identify PMI deaths occurring within the U.S. between 1999- 2020. We calculated trends in the proportional mortality of PMI using the Joinpoint regression analysis. Results From 1999-2020, we identified a total of 3,017,826 AMI-related deaths. Of these 373,317 were PMI deaths, corresponding to proportional mortality of 12.5% (male 12%, female 14%). On trend analysis, the proportional mortality of PMI increased from 10.5% in 1999 to 13.2% in 2020 [AAPC of 1.0 (0.8 to 1.2, p<0.01)] with a significant increase in females from 10% in 1999 to 17% in 2020 [AAPC of 2.4 (1.8 to 3.0, p<0.01)] and no significant change in males, 11% in 1999 to 10% in 2020 [AAPC of -0.2 (-0.7 to 0.3, p=0.4)]. There was a significant increase in proportional mortality in both Blacks (18% in 1999 to 21% in 2020) and Whites (10% in 1999 to 12% in 2020), with no statistical difference among American Indian or Alaska Native, Asian or Pacific Islander, or Hispanics. Conclusion Over the last 2 decades there has been a significant increase in the proportional mortality of PMI in females and black population in spite of the overall downtrend in AMI-related mortality.AMI mortalityAMI mortality based on race