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阵发性心动过速所致死亡患者的趋势、性别及种族差异:一项1999 - 2020年的全国性分析

Trends, gender, and racial disparities in patients with mortality due to paroxysmal tachycardia: A nationwide analysis from 1999-2020.

作者信息

Goyal Aman, Saeed Humza, Yamin Saif, Sultan Wania, Arshad Muhammad Khubaib, Sulaiman Samia Aziz, Changez Mah I Kan, Mahalwar Gauranga

机构信息

Department of Internal Medicine, Seth GS Medical College and KEM Hospital, Mumbai, India.

Department of Internal Medicine, Rawalpindi Medical University, Rawalpindi, Pakistan.

出版信息

PLoS One. 2025 Feb 4;20(2):e0314715. doi: 10.1371/journal.pone.0314715. eCollection 2025.

Abstract

BACKGROUND

Paroxysmal tachycardia encompasses various heart rhythm disorders that cause rapid heart rates. Its episodic occurrence makes it difficult to identify and measure its prevalence and trends in the population. Additionally, there is limited data on disparities and trends in mortality due to paroxysmal tachycardia, which is essential for assessing current medical approaches and identifying at-risk populations.

METHODS

Our study examined death certificates from 1999 to 2020 using the CDC WONDER Database to identify deaths caused by paroxysmal tachycardia in individuals aged 25 and older, using the ICD-10 code I47. Age-adjusted mortality rates (AAMRs) and annual percent changes (APC) were calculated by year, gender, age group, race/ethnicity, geographic location, and urbanization status. Trends in AAMRs were analyzed using the Joinpoint Regression Program to identify significant changes and inflection points in mortality trends throughout the study period.

RESULTS

Between 1999 and 2020, 155,320 deaths were reported in patients with paroxysmal tachycardia. Overall, AAMR decreased from 4.8 to 3.7 per 100,000 population between 1999 and 2020, despite showing a significant increase from 2014 to 2020 (APC: 4.33; 95% CI: 3.53 to 5.56). Men had consistently higher AAMRs than women (4.7 vs. 2.2). Furthermore, we found that AAMRs were highest among Non-Hispanic (NH) Black or African Americans and lowest in NH Asian or Pacific Islanders (4 vs. 1.9). Nonmetropolitan areas had higher AAMRs than metropolitan areas (3.6 vs. 3.2).

CONCLUSIONS

Our analysis showed a significant decrease in mortality from paroxysmal tachycardia since 1999, although there has been a slight increase in recent years. However, disparities remain, with higher AAMRs among men, NH Black or African Americans, and residents of non-metropolitan areas. These findings call for immediate public health actions to curb the rising trends and reduce potential disparities.

摘要

背景

阵发性心动过速包括各种导致心率加快的心律失常。其发作性的特点使得难以确定和衡量其在人群中的患病率及趋势。此外,关于阵发性心动过速导致的死亡率差异和趋势的数据有限,而这些数据对于评估当前的医疗方法和识别高危人群至关重要。

方法

我们的研究使用疾病控制与预防中心(CDC)的WONDER数据库,检查了1999年至2020年的死亡证明,以确定25岁及以上个体中由阵发性心动过速导致的死亡,使用国际疾病分类第十版(ICD - 10)编码I47。按年份、性别、年龄组、种族/族裔、地理位置和城市化状态计算年龄调整死亡率(AAMR)和年度百分比变化(APC)。使用Joinpoint回归程序分析AAMR的趋势,以确定整个研究期间死亡率趋势的显著变化和转折点。

结果

1999年至2020年期间,报告了155,320例阵发性心动过速患者的死亡。总体而言,1999年至2020年期间,AAMR从每10万人4.8降至3.7,尽管在2014年至2020年期间有显著上升(APC:4.33;95%可信区间:3.53至5.56)。男性的AAMR一直高于女性(4.7对2.2)。此外,我们发现非西班牙裔(NH)黑人或非裔美国人的AAMR最高,而NH亚裔或太平洋岛民最低(4对1.9)。非都市地区的AAMR高于都市地区(3.6对3.2)。

结论

我们的分析表明,自1999年以来阵发性心动过速导致的死亡率显著下降,尽管近年来略有上升。然而,差异仍然存在,男性、NH黑人或非裔美国人以及非都市地区居民的AAMR较高。这些发现呼吁立即采取公共卫生行动,以遏制上升趋势并减少潜在差异

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