Shuja Muhammad Hamza, Hannat Ramish, Shahid Ahmad, Meer Komail Khalid, Mubbashir Ayesha, Edhi Maliha, Ullah Irfan, Alareed Ahmad, Paray Nitish Behary, Ahmed Raheel, Cortese Bernardo, Hall Michael E
Dow University of Health Sciences, Karachi, Pakistan.
Services Institute of Medical Sciences (SIMS), Lahore, Pakistan.
Clin Cardiol. 2025 Aug;48(8):e70191. doi: 10.1002/clc.70191.
Acute myocardial infarction (AMI) remains a leading cause of mortality in the USA, particularly among individuals aged 65 and older. There is limited research about the association between psychoactive substance use and cardiovascular death due to AMI. This study aims to analyze trends in AMI-related mortality among older adults (aged ≥ 65) associated with psychoactive substance use in the USA from 1999 to 2020, with a focus on demographic and geographic variations.
We conducted a descriptive analysis using death certificates from the CDC's WONDER database. Data were extracted for age, sex, race/ethnicity, urban-rural status, and geographic region. Crude mortality rates and AAMR were calculated, and temporal trends were assessed using Joinpoint regression.
Between 1999 and 2020, there were 231 359 AMI-related deaths among older adults with substance use disorders. Men (39.2) had a markedly higher mortality rate than women (15.0). Mortality rates increased across all age groups, with the most pronounced rise in those aged 85 and older (33.9). Metropolitan areas (22.3) experienced lower mortality rates than nonmetropolitan areas (37.9). The Midwest (32.3) consistently recorded the highest mortality rates, followed by the Northeast (25.0), South (24.5), and West (18.7).
The study reveals notable temporal trends in AMI mortality among older adults with psychoactive substance use, highlighting significant demographic and regional disparities. These findings underscore the need for targeted interventions to address this growing public health issue.
急性心肌梗死(AMI)仍然是美国主要的死亡原因,尤其是在65岁及以上的人群中。关于精神活性物质使用与AMI导致的心血管死亡之间的关联,研究有限。本研究旨在分析1999年至2020年美国65岁及以上老年人中与精神活性物质使用相关的AMI相关死亡率趋势,重点关注人口统计学和地理差异。
我们使用疾病控制与预防中心(CDC)的WONDER数据库中的死亡证明进行描述性分析。提取了年龄、性别、种族/族裔、城乡状况和地理区域的数据。计算了粗死亡率和年龄调整死亡率,并使用Joinpoint回归评估时间趋势。
1999年至2020年期间,患有物质使用障碍的老年人中有231359例与AMI相关的死亡。男性(39.2)的死亡率明显高于女性(15.0)。所有年龄组的死亡率均有所上升,85岁及以上人群的上升最为明显(33.9)。大都市地区(22.3)的死亡率低于非大都市地区(37.9)。中西部地区(32.3)的死亡率一直最高,其次是东北部(25.0)、南部(24.5)和西部(18.7)。
该研究揭示了患有精神活性物质使用障碍的老年人中AMI死亡率的显著时间趋势,突出了显著的人口统计学和地区差异。这些发现强调了需要有针对性的干预措施来解决这一日益严重的公共卫生问题。