Trends in stroke-related mortality in atrial fibrillation patients in the United States: Insights from the CDC WONDER database
Background: Stroke associated with atrial fibrillation (AF) is a significant cause of mortality. This study analyzed demographic trends and disparities in mortality rates due to stroke in AF patients aged ≥25 years. Methods: A retrospective analysis was conducted to acquire death data using the Cent...
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Elsevier
2025-01-01
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| Series: | American Heart Journal Plus |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666602224001344 |
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| author | Muhammad Abdullah Naveed Sivaram Neppala Himaja Dutt Chigurupati Muhammad Omer Rehan Ahila Ali Hamza Naveed Bazil Azeem Rabia Iqbal Manahil Mubeen Mashood Ahmed Ayman R. Fath Timir Paul Bilal Munir |
| author_facet | Muhammad Abdullah Naveed Sivaram Neppala Himaja Dutt Chigurupati Muhammad Omer Rehan Ahila Ali Hamza Naveed Bazil Azeem Rabia Iqbal Manahil Mubeen Mashood Ahmed Ayman R. Fath Timir Paul Bilal Munir |
| author_sort | Muhammad Abdullah Naveed |
| collection | DOAJ |
| description | Background: Stroke associated with atrial fibrillation (AF) is a significant cause of mortality. This study analyzed demographic trends and disparities in mortality rates due to stroke in AF patients aged ≥25 years. Methods: A retrospective analysis was conducted to acquire death data using the Centers for Disease Control and Prevention database from 1999 to 2020. Age-adjusted mortality rates (AAMRs) were calculated per 100,000 persons, and trends were assessed using Average Annual Percentage Change (AAPC) and annual percent change (APC). Data were stratified by year, sex, race/ethnicity, and geographical regions. Results: Between 1999 and 2020, AF-associated stroke contributed to 331,106 deaths among adults in this study population. Deaths occurred predominantly in medical facilities (43.2 %). The overall AAMR for AF-associated stroke decreased from 7.4 in 1999 to 6.4 in 2020, with an APC of −1.02 (p-value = 0.004). Additionally, AAMR showed a significant decline from 2015 to 2018 with an APC of −7.22 (p-value <0.000001), followed by a striking rise from 2018 to 2020 (APC: 4.98) (p-value = 0.0008). Women had slightly higher AAMR than men (men: 6.6; women: 7.1) (p value = 0.02). AAMRs varied among racial/ethnic groups, with Whites having the highest AAMR (7.4), followed by Blacks (5.4), American Indian or Alaska Natives (4.6), Asian or Pacific Islanders (4.5), and Hispanics (4.1). AAMRs decreased for all races except Blacks. Geographically, AAMRs ranged from 4.3 in Nevada to 11.9 in Vermont, with the Western region showing the highest mortality (AAMR: 7.9). Nonmetropolitan areas had slightly higher AAMRs than metropolitan areas, with both experiencing a decrease over the study period. Conclusion: This analysis depicts significant demographic and geographic disparities in mortality rates attributed to stroke associated with AF. Targeted interventions and equitable healthcare access are crucial to mitigate these disparities and improve outcomes for this population. |
| format | Article |
| id | doaj-art-98bba015ecc34737a4914e6c731742c5 |
| institution | Kabale University |
| issn | 2666-6022 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Heart Journal Plus |
| spelling | doaj-art-98bba015ecc34737a4914e6c731742c52025-01-07T04:17:35ZengElsevierAmerican Heart Journal Plus2666-60222025-01-0149100491Trends in stroke-related mortality in atrial fibrillation patients in the United States: Insights from the CDC WONDER databaseMuhammad Abdullah Naveed0Sivaram Neppala1Himaja Dutt Chigurupati2Muhammad Omer Rehan3Ahila Ali4Hamza Naveed5Bazil Azeem6Rabia Iqbal7Manahil Mubeen8Mashood Ahmed9Ayman R. Fath10Timir Paul11Bilal Munir12Department of Cardiology, Dow Medical College, Dow University of Health Sciences, Karachi, PakistanDivision of Cardiology, The University of Texas Health Sciences Center, San Antonio, TX, USA; Corresponding author.Department of Internal Medicine, New York Medical College at Saint Michael's Medical Center, Newark, NJ 07102, USADepartment of Cardiology, Dow Medical College, Dow University of Health Sciences, Karachi, PakistanDepartment of Cardiology, Dow Medical College, Dow University of Health Sciences, Karachi, PakistanDepartment of Internal Medicine, Queen Elizabeth the Queen Mother Hospital, EKHUFT, Margate, Kent, United KingdomDepartment of Cardiology, Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi, PakistanDepartment of Cardiology, Dow Medical College, Dow University of Health Sciences, Karachi, PakistanDepartment of Cardiology, Dow Medical College, Dow University of Health Sciences, Karachi, PakistanDepartment of Medicine, Rawalpindi Medical University, Rawalpindi, PakistanDivision of Cardiology, The University of Texas Health Sciences Center, San Antonio, TX, USADepartment of Cardiovascular Sciences, Ascension St. Thomas Hospital, University of Tennessee Health Sciences Center, Nashville, TN, USADepartment of Cardiac Electrophysiology, University of California Davis Health, Sacramento, CA, USABackground: Stroke associated with atrial fibrillation (AF) is a significant cause of mortality. This study analyzed demographic trends and disparities in mortality rates due to stroke in AF patients aged ≥25 years. Methods: A retrospective analysis was conducted to acquire death data using the Centers for Disease Control and Prevention database from 1999 to 2020. Age-adjusted mortality rates (AAMRs) were calculated per 100,000 persons, and trends were assessed using Average Annual Percentage Change (AAPC) and annual percent change (APC). Data were stratified by year, sex, race/ethnicity, and geographical regions. Results: Between 1999 and 2020, AF-associated stroke contributed to 331,106 deaths among adults in this study population. Deaths occurred predominantly in medical facilities (43.2 %). The overall AAMR for AF-associated stroke decreased from 7.4 in 1999 to 6.4 in 2020, with an APC of −1.02 (p-value = 0.004). Additionally, AAMR showed a significant decline from 2015 to 2018 with an APC of −7.22 (p-value <0.000001), followed by a striking rise from 2018 to 2020 (APC: 4.98) (p-value = 0.0008). Women had slightly higher AAMR than men (men: 6.6; women: 7.1) (p value = 0.02). AAMRs varied among racial/ethnic groups, with Whites having the highest AAMR (7.4), followed by Blacks (5.4), American Indian or Alaska Natives (4.6), Asian or Pacific Islanders (4.5), and Hispanics (4.1). AAMRs decreased for all races except Blacks. Geographically, AAMRs ranged from 4.3 in Nevada to 11.9 in Vermont, with the Western region showing the highest mortality (AAMR: 7.9). Nonmetropolitan areas had slightly higher AAMRs than metropolitan areas, with both experiencing a decrease over the study period. Conclusion: This analysis depicts significant demographic and geographic disparities in mortality rates attributed to stroke associated with AF. Targeted interventions and equitable healthcare access are crucial to mitigate these disparities and improve outcomes for this population.http://www.sciencedirect.com/science/article/pii/S2666602224001344Atrial fibrillationStrokeAge-adjusted mortality ratesRaceEthnicitySex |
| spellingShingle | Muhammad Abdullah Naveed Sivaram Neppala Himaja Dutt Chigurupati Muhammad Omer Rehan Ahila Ali Hamza Naveed Bazil Azeem Rabia Iqbal Manahil Mubeen Mashood Ahmed Ayman R. Fath Timir Paul Bilal Munir Trends in stroke-related mortality in atrial fibrillation patients in the United States: Insights from the CDC WONDER database American Heart Journal Plus Atrial fibrillation Stroke Age-adjusted mortality rates Race Ethnicity Sex |
| title | Trends in stroke-related mortality in atrial fibrillation patients in the United States: Insights from the CDC WONDER database |
| title_full | Trends in stroke-related mortality in atrial fibrillation patients in the United States: Insights from the CDC WONDER database |
| title_fullStr | Trends in stroke-related mortality in atrial fibrillation patients in the United States: Insights from the CDC WONDER database |
| title_full_unstemmed | Trends in stroke-related mortality in atrial fibrillation patients in the United States: Insights from the CDC WONDER database |
| title_short | Trends in stroke-related mortality in atrial fibrillation patients in the United States: Insights from the CDC WONDER database |
| title_sort | trends in stroke related mortality in atrial fibrillation patients in the united states insights from the cdc wonder database |
| topic | Atrial fibrillation Stroke Age-adjusted mortality rates Race Ethnicity Sex |
| url | http://www.sciencedirect.com/science/article/pii/S2666602224001344 |
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