Abstract Details

Title Trends in Mortality Associated with Acute Ischemic Stroke and Heart Failure in the United States, 1999-2020

Topic Cerebrovascular Disease and Interventional Neurology

Presentation(s) P2 - Poster Session 2 (11:45 AM-12:45 PM)

Poster/Presentation
Number 5-016

Objective Describe mortality trends from 1999 to 2020 among patients with Heart Failure (HF) and Acute Ischemic Stroke(AIS)

Background AIS and HF are major causes of U.S. mortality, often co-occurring due to shared risk factors. Despite treatment advances, temporal trends in combined AIS-HF mortality are understudied. This analysis examines national mortality patterns to guide neurologic and cardiovascular interventions.

Design/Methods This was a retrospective analysis of the CDC WONDER Multiple Cause of Death database for deaths among adults aged ≥25 years where HF was the underlying or contributing cause and AIS was listed among multiple causes (ICD-10: I50, I63). Data from 1999-2020 were stratified by age, sex, race/ethnicity, and state. Age-adjusted mortality rates (AAMRs) were standardized to the 2000 U.S. population. Temporal trends were assessed, calculating annual percentage change (APC) and average annual percent change (AAPC) with 95% confidence intervals (p<0.05)

Results

AIS-HF AAMR declined from 1999-2004 (APC: -10.54; 95% CI: -14.08 to -6.83; p<0.05) and 2004-2007 (APC: -20.80; 95% CI: -43.61 to 11.23; p=0.15), slowing from 2007-2014 (95% CI: -5.2 to -1.7; p=0.30). Rates rose sharply from 2014-2017 (APC: 36.87; 95% CI: 8.7 to 72.32; p<0.05) and 2017-2020 (APC: 12.53; 95% CI: 4.8 to 20.80; p<0.05). The overall AAPC (1999-2020) was nonsignificant (-0.39; 95% CI: -5.47 to 4.94; p=0.88). By sex, males and females showed declines until ~2008, reversing to significant increases from 2014-2020. Racial/ethnic trends mirrored this pattern, with non-Hispanic Blacks and Hispanics/Latinos showing sharper recent increases, though overall AAPCs remained nonsignificant.

Conclusions Early declines in AIS-HF mortality reversed after ~2014, possibly due to aging populations or care disparities. Targeted interventions, especially for minority groups, are critical to address this rising burden. Geographic analyses could identify key areas for intervention.

Authors/Disclosures
Prince K. Pekyi-Boateng, MBBS PRESENTER	Dr. Pekyi-Boateng has nothing to disclose.
Sylvia Tawiah-Eshun, MBBS, MBCHB	Dr. Tawiah-Eshun has nothing to disclose.
Rutvi Amin, MBBS	Dr. Amin has nothing to disclose.
Courage K. Dogbe, MBBS	Dr. Dogbe has nothing to disclose.
Kamleshun Ramphul	Kamleshun Ramphul has nothing to disclose.
Jana Wold, MD (University of Utah Medical Center)	Dr. Wold has nothing to disclose.

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