# Trends in Chronic Ischemic Heart Disease‐Related Mortality in Older Adults With Atrial Fibrillation (1999–2023): A CDC WONDER Database Analysis

## TL;DR

This study shows that deaths from chronic heart disease in older adults with atrial fibrillation have risen significantly in the U.S. since 2010, with notable differences by sex, race, and location.

## Contribution

The study provides updated trends in chronic IHD mortality among older adults with AF using CDC WONDER data from 1999 to 2023, highlighting disparities and rising rates.

## Key findings

- Age-adjusted mortality rates increased from 38.2 in 1999 to 52.2 in 2023, with a notable rise after 2010.
- Males had double the mortality rate of females, and non-Hispanic Whites had higher rates than other racial/ethnic groups.
- Non-metropolitan and Northeast regions had higher mortality rates compared to other geographic areas.

## Abstract

Atrial fibrillation (AF) is the most common and persistent type of arrhythmia that frequently co‐exists with chronic ischemic heart disease (IHD), increasing the risk of adverse cardiovascular outcomes and mortality. We aim to analyze chronic IHD‐related mortality trends in patients with AF from 1999 to 2023 in the United States (U.S.).

Centers for Disease Control and Prevention's Wide‐Ranging Online Data for Epidemiologic Research (CDC WONDER) database was used to conduct a retrospective analysis of death records of adults (aged 65 ≤) with chronic IHD as the underlying cause and co‐existent AF as a contributing cause of death. Age‐adjusted mortality rates (AAMR) per 100 000 population and annual percent changes (APC) in age‐adjusted mortality rates were determined and measured across different demographics and geographies in the U.S.

AF was recorded in almost 460,196 deaths caused by chronic IHD. The AAMR increased from 38.2 in 1999 to 52.2 in 2023, showing a prominent increase shift from 2010 to 2023 (APC: 2.72). Recorded AAMR in Males (54.8) was doubled that of females (33.2), while a top AAMR of 44.7 was seen in non‐Hispanic (NH) Whites was doubled that of other racial/ethnic groups. Geographically, AAMR was higher in non‐metropolitan areas (43.3) and the Northeast region (42.8).

Proper resource distribution and more targeted interventions are needed to address the rising trends in chronic IHD mortality among AF patients across different geographic and demographic groups.

This study highlights rising age‐adjusted mortality rates from chronic ischemic heart disease in older adults with atrial fibrillation (1999–2023), with significant increases after 2010. Key disparities were observed by sex, race/ethnicity, urbanicity, and geography, emphasizing a need for targeted public health interventions