Akhtar Muzamil, Khan Rafi Ullah, Saadia Sheema, Dawood Muhammad Hamza, Khan Muheem, Collins Peter, Sauer Andrew J, Ahmed Raheel
Department of Medicine, Gujranwala Medical College, Gujranwala, Pakistan.
Department of Medicine, Gomal Medical College, Dera Ismail Khan, Pakistan.
Nutr Metab Cardiovasc Dis. 2025 Apr 16:104063. doi: 10.1016/j.numecd.2025.104063.
BACKGROUND AND AIMS: Acute myocardial infarction (AMI) and type 2 diabetes mellitus (T2DM) are leading causes of mortality, with significant demographic and regional disparities. This study examined mortality trends related to AMI and T2DM among U.S. adults aged ≥25 years from 1999 to 2022. METHODS AND RESULTS: Using the CDC WONDER database, we analyzed death certificates where AMI (ICD-10: I21, I22) and T2DM (ICD-10: E11) were listed as underlying or contributing causes. Age-adjusted mortality rates (AAMRs) per 100,000 population and annual percent change (APC) were calculated and stratified by year, sex, race/ethnicity, and region. Between 1999 and 2022, 196,326 deaths were recorded. AAMRs increased from 3.35 in 1999 to 3.66 in 2003 (APC: 2.39; 95 % CI, -0.69-8.71; p = 0.14), declined to 3.08 in 2014 (APC: -1.75∗; 95 % CI, -4.66 to -0.51; p = 0.05), then significantly rose to 4.64 in 2022 (APC: 6.19∗; 95 % CI, 4.89-7.78; p = 0.002). Men had consistently higher AAMRs than women, rising from 4.30 vs. 2.67 in 1999 to 6.42 vs. 3.18 in 2022. Hispanics had the highest AAMR, followed by non-Hispanic (NH) Black, NH Other, and NH White populations. Regionally, the highest mortality rates were observed in West Virginia and non-metropolitan areas. CONCLUSION: Mortality rates associated with AMI and T2DM have demonstrated an upward trajectory from 2014 to 2022. Notable geographic and demographic disparities remain evident, underscoring the critical need for further research and the implementation of targeted health policy interventions to mitigate these inequalities.
背景与目的：急性心肌梗死（AMI）和2型糖尿病（T2DM）是主要的死亡原因，存在显著的人口统计学和地区差异。本研究调查了1999年至2022年美国25岁及以上成年人中与AMI和T2DM相关的死亡率趋势。 方法与结果：利用美国疾病控制与预防中心（CDC）的WONDER数据库，我们分析了将AMI（国际疾病分类第十版：I21、I22）和T2DM（国际疾病分类第十版：E11）列为根本原因或促成原因的死亡证明。计算了每10万人口的年龄调整死亡率（AAMR）和年度百分比变化（APC），并按年份、性别、种族/民族和地区进行分层。1999年至2022年期间，记录了196,326例死亡。AAMR从1999年的3.35上升至2003年的3.66（APC：2.39；95%置信区间，-0.69-8.71；p=0.14），2014年降至3.08（APC：-1.75∗；95%置信区间，-4.66至-0.51；p=0.05），然后在2022年显著升至4.64（APC：6.19∗；95%置信区间，4.89-7.78；p=0.002）。男性的AAMR一直高于女性，从1999年的4.30对2.67升至2022年的6.42对3.18。西班牙裔的AAMR最高，其次是非西班牙裔（NH）黑人、NH其他种族和NH白人人群。在地区方面，西弗吉尼亚州和非都市地区的死亡率最高。 结论：2014年至2022年期间，与AMI和T2DM相关的死亡率呈上升趋势。显著的地理和人口统计学差异仍然明显，这突出表明迫切需要进一步研究并实施有针对性的卫生政策干预措施，以减轻这些不平等现象。
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