Muhammad Abdullah Naveed, Neppala Sivaram, Rehan Muhammad Omer, Ali Ahila, Naveed Hamza, Iqbal Rabia, Azeem Bazil, Chikatimalla Rahul, Kapaganti Sowjanya, Ahmed Mushood, Shuja Hamza, Chigurupati Himaja Dutt, Sattar Yasir, Rana Jamal S
From the Department of Cardiology, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
Division of Cardiology, The University of Texas Health Sciences Center, San Antonio, TX.
Cardiol Rev. 2025 Jul 7. doi: 10.1097/CRD.0000000000000992.
Peripheral artery disease (PAD) is a common progressive atherosclerotic condition that significantly affects morbidity and mortality in the United States. However, data on PAD-related mortality trends are limited. This study investigates contemporary mortality trends across various sociodemographic and regional factor groups. CDC-WONDER (1999-2024) data were analyzed to assess PAD-related mortality in patients aged ≥25. Using the Joinpoint regression analysis, we calculated age-adjusted mortality rates (AAMR) per 100,000 patients and average annual percentage changes (AAPCs) to analyze the mortality trends. PAD accounted for 793,773 deaths between 1999 and 2024. The AAMRs decreased from 18.0 in 1999 to 13.0 in 2024 (AAPC: -1.37). The most significant decline occurred from 1999 to 2010 [annual percent change (APC): -3.46] and 2021 to 2024 (APC: -3.96). However, there was a concerning rise from 2018 to 2021 (APC: 5.42), possibly due to the pandemic, all with P < 0.01. Disparities are evident, as men have higher AAMRs than women (16.8 vs. 11.4), and non-Hispanic (NH) Black individuals are at the highest risk (AAMR: 28.8), followed by NH Whites (AAMR: 13.6). Regionally, West Virginia reports the highest AAMR at 18.5, in contrast to Utah's lowest rate of 7.1. Moreover, rural areas exhibited higher AAMRs than urban settings (15.2 vs. 13.2). In the United States, mortality trends among patients with PAD have significantly declined; however, from 2018 to 2021, these trends experienced a reversal, likely influenced by the COVID-19 pandemic. Enhancing healthcare access and implementing targeted interventions can mitigate these disparities and improve patient outcomes.
外周动脉疾病（PAD）是一种常见的进行性动脉粥样硬化疾病，在美国对发病率和死亡率有重大影响。然而，关于PAD相关死亡率趋势的数据有限。本研究调查了不同社会人口统计学和区域因素组的当代死亡率趋势。分析了疾病控制与预防中心（CDC）的WONDER（1999 - 2024年）数据，以评估25岁及以上患者中与PAD相关的死亡率。使用Joinpoint回归分析，我们计算了每10万名患者的年龄调整死亡率（AAMR）和平均年度百分比变化（AAPC），以分析死亡率趋势。1999年至2024年期间，PAD导致793,773人死亡。AAMR从1999年的18.0降至2024年的13.0（AAPC：-1.37）。最显著的下降发生在1999年至2010年[年度百分比变化（APC）：-3.46]以及2021年至2024年（APC：-3.96）。然而，2018年至2021年出现了令人担忧的上升（APC：5.42），可能是由于疫情，所有这些P值均<0.01。差异明显，男性的AAMR高于女性（16.8对11.4），非西班牙裔（NH）黑人个体风险最高（AAMR：28.8），其次是NH白人（AAMR：13.6）。在区域方面，西弗吉尼亚州报告的AAMR最高，为18.5，而犹他州最低，为7.1。此外，农村地区的AAMR高于城市地区（15.2对13.2）。在美国，PAD患者的死亡率趋势显著下降；然而，2018年至2021年期间，这些趋势出现了逆转，可能受到2019冠状病毒病疫情的影响。加强医疗服务可及性并实施有针对性的干预措施能够减轻这些差异并改善患者预后。
