Heart of the matter: Navigating trends and disparities in cardiovascular mortality among patients with amyloidosis in the United States (1999-2020)

Background: There is a growing recognition of the detrimental effects of amyloidosis disease on the cardiovascular system. This study sought to assess the longitudinal trends of cardiovascular deaths (CVDs) with amyloidosis as a contributing cause in the United States. Method: We queried the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research database for cardiovascular mortality with amyloidosis as a contributing cause among patients aged 35 and above. Diseases of the circulatory system (ICD-10 I00-I99) were listed as the underlying cause of death, and amyloidosis (ICD-10 E85) as contributing cause of death. We calculated age-adjusted mortality rates (AAMRs) per 1,000,000 individuals and determined the trends over time by estimating the annual percent change using the Joinpoint Regression Program. Results: In the 22-year study period, 4145 CVDs with amyloidosis as a contributing cause in the United States were identified between 1999 and 2020. The AAMRs increased significantly from 0.69 (95 % CI, 0.56-0.85) per 1,000,000 individuals in 1999 to 2.13 (95 % CI, 1.93-2.33) per 1,000,000 individuals in 2020, with an annual percent increase of + 3.92. The AAMRs for the span of 22 years were higher in males than females (1.66 [95 % CI, 1.59-1.73] vs. 0.75 [95 % CI, 0.71-0.78]). When stratified by race, African American populations had the highest cumulative AAMR (2.34 [95 % CI, 2.18-2.51]) compared to other racial groups. In terms of urbanization, the AAMR was significantly higher in the urban regions compared to the rural areas (1.15 [95 % CI, 1.11-1.19] vs. 0.91 [95 % CI, 0.84-0.98]). Conclusion: Our analysis revealed that the AAMR from CVDs with amyloidosis as a contributing cause has increased over the last two decades, with significant disparities seen in male and African-American individuals.