Imran Zahra, Khan Taimor Mohammed, Waqas Saad Ahmed, Ahmed Raheel, Minhas Abdul Mannan Khan
Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan.
National Heart and Lung Institute, Imperial College London, London, UK.
Int J Cardiol Congenit Heart Dis. 2025 Jun 30;21:100607. doi: 10.1016/j.ijcchd.2025.100607. eCollection 2025 Sep.
Congenital heart disease (CHD) remains the leading cause of infant mortality due to birth defects in the United States. We analyzed long-term CHD mortality trends across age, sex, and racial groups from 1968 to 2022.
We extracted CHD mortality data from the CDC WONDER database (1968-2022), using ICD-8/9/10 codes. Age-adjusted mortality rates (AAMRs) and crude mortality rates (CMRs) were calculated per 100,000 population. Joinpoint regression was used to assess temporal trends in mortality, reporting annual percentage changes (APCs) and average APCs (AAPCs) with 95 % confidence intervals (CIs).
From 1968 to 2019, 234,658 CHD-related deaths were recorded. Overall AAMR declined from 3.2 (1968) to 0.8 (2019) per 100,000 (AAPC: -2.7 %; 95 % CI: -2.9 to -2.5). Males consistently had higher AAMRs than females. Racial disparities persisted, with slower declines among Black or African American individuals. Infants under 1 year accounted for 56.0 % of CHD deaths and showed the steepest mortality decline (AAPC: -3.2 %). Mortality rates plateaued in recent years.
CHD mortality in the U.S. has declined markedly over the past five decades, though progress has slowed since 2009. Persistent disparities by race and sex emphasize the need for equitable access to specialized CHD care and ongoing public health efforts.
在美国，先天性心脏病（CHD）仍是婴儿因出生缺陷导致死亡的主要原因。我们分析了1968年至2022年不同年龄、性别和种族群体中CHD的长期死亡率趋势。
我们使用ICD - 8/9/10编码从美国疾病控制与预防中心（CDC）的WONDER数据库中提取CHD死亡率数据。按每10万人计算年龄调整死亡率（AAMR）和粗死亡率（CMR）。采用连接点回归评估死亡率的时间趋势，报告年度百分比变化（APC）和平均年度百分比变化（AAPC）及其95%置信区间（CI）。
1968年至2019年，共记录了234,658例与CHD相关的死亡病例。总体AAMR从1968年的每10万人3.2例降至2019年的0.8例（AAPC：-2.7%；95%CI：-2.9至-2.5）。男性的AAMR一直高于女性。种族差异持续存在，黑人或非裔美国人的下降速度较慢。1岁以下婴儿占CHD死亡病例的56.0%，死亡率下降最为陡峭（AAPC：-3.2%）。近年来死亡率趋于平稳。
在过去五十年中，美国CHD死亡率显著下降，但自2009年以来进展有所放缓。种族和性别的持续差异凸显了公平获得专门CHD护理以及持续开展公共卫生工作的必要性。
