Temporal Trends in Mortality Related to Stroke and Atrial Fibrillation in the United States: A 21‐Year Retrospective Analysis of CDC‐WONDER Database

Ahmad, Owais; Farooqi, Hanzala Ahmed; Ahmed, Isra; Jamil, Adeena; Nabi, Rayyan; Ullah, Irfan; Khan, Abdul Wali; Ahmed, Raheel; Alam, Mahboob; Cortese, Bernardo; Mamas, Mamas A.

Abstract

Aims: Atrial Fibrillation (AF) is one of the most strongly associated risk factors for stroke. Our study aims to analyze changes in mortality from 1999 to 2020 in patients with AF and stroke. Methods: Using the Centre for Disease Control and Prevention Wide‐Ranging Online Data for Epidemiologic Research (CDC‐WONDER), we retrospectively analyzed annual age‐adjusted mortality rates (AAMR) per million from 1999 to 2020 in stroke patients with AF. Temporal trends were analyzed, and Annual Percentage Change (APC) was calculated using the JoinPoint regression model across variations in demographics (sex, race) and regional subgroups. Results: Around 490 000 deaths were reported between 1999 and 2020 from stroke and AF across the 25–85+ age group. AAMR initially decreased until 2008 (APC = –0.9), followed by an increase till 2020 (APC = 1.1). Women had a higher AAMR than men throughout the years. Non‐Hispanic white patients had a marginally higher AAMR than all other races and ethnicities. The highest AAMR was observed in the western region. States like Vermont, Oregon, Washington, Alaska, Minnesota, and West Virginia were in the top 90th percentile, while Nevada, Louisiana, Florida, New York, New Mexico, and Arizona were in the bottom 10th percentile. Nonmetropolitan areas had consistently higher AAMRs throughout the 2 decades. Conclusion: An overall rise in mortality has been observed in stroke and AF patients, with a greater surge in 2019. The need for healthcare policy changes, especially in areas with high mortality and awareness of healthier lifestyle factors, can be an essential preventative measure to help mitigate growing mortality rates.

Citation

Ahmad, O., Farooqi, H. A., Ahmed, I., Jamil, A., Nabi, R., Ullah, I., Khan, A. W., Ahmed, R., Alam, M., Cortese, B., & Mamas, M. A. (2024). Temporal Trends in Mortality Related to Stroke and Atrial Fibrillation in the United States: A 21‐Year Retrospective Analysis of CDC‐WONDER Database. Clinical Cardiology, 47(12), e70058. https://doi.org/10.1002/clc.70058

• Journal Article Type: Article
• Acceptance Date: Nov 19, 2024
• Online Publication Date: Dec 16, 2024
• Publication Date: Dec 1, 2024
• Deposit Date: Jan 13, 2025
• Publicly Available Date: Jan 13, 2025
• Journal: Clinical Cardiology
• Print ISSN: 0160-9289
• Electronic ISSN: 1932-8737
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 47
• Issue: 12
• Pages: e70058
• DOI: https://doi.org/10.1002/clc.70058
• Keywords: temporal trends, stroke, atrial fibrillation, mortality, CDC wonder
• Public URL: https://keele-repository.worktribe.com/output/1020419