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Cardiovascular Mortality in Amyloidosis: Long-Term Trends; Disparities; and Projections in the United States
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DOI：10.2147/RMHP.S607682.png)
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Zhan Chen,1 Ying Tian,2 Yue Zhang3 1Department of Vascular Surgery, Beijing Haidian Hospital, Beijing, People’s Republic of China; 2Department of Hematology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, People’s Republic of China; 3Department of Scientific Research, Beijing Haidian Hospital, Beijing, People’s Republic of China Correspondence: Yue Zhang, Email yue_chen99@sina.com Ying Tian, Email 13810060987@163.com Background: Cardiac involvement is a major determinant of prognosis in systemic amyloidosis, but population-level trends in cardiovascular mortality remain insufficiently characterized. Methods: We performed a retrospective, population-based analysis of U.S. adults aged ≥ 45 years with amyloidosis using death certificate data from the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database from 1999 through 2023. Cardiovascular disease (CVD)–related deaths were identified using ICD-10 codes and classified into heart failure (HF), atrial fibrillation/flutter (AF), ischemic heart disease (IHD), or other CVD categories. Age-adjusted mortality rates (AAMRs) were calculated using the 2000 U.S. standard population. Joinpoint regression assessed temporal trends, and autoregressive integrated moving average (ARIMA) models projected mortality through 2033. Results: A total of 35,222 CVD-related deaths occurred among adults with amyloidosis during the study period, yielding an overall AAMR of 1.12 per 100,000 population. Cardiovascular mortality increased nearly threefold, from 0.80 per 100,000 in 1999 to 2.27 per 100,000 in 2023, with a marked acceleration beginning in the late 2010s. HF consistently accounted for the largest proportion of CVD-related deaths. Mortality rates were higher among males, older adults, and non-Hispanic Black individuals, with demographic and geographic disparities widening over time. Similar upward trajectories were observed across U.S. Census regions and levels of urbanization. Projections indicated continued increases in cardiovascular mortality through 2033. Conclusion: Cardiovascular mortality among U.S. adults with amyloidosis has increased substantially over the past 25 years, with recent acceleration and persistent population-level disparities. These findings highlight a growing public health burden and support earlier detection, equitable access to specialized care, and continued national surveillance. Keywords: amyloidosis, cardiac amyloidosis, cardiovascular mortality, population-based study, health disparities, CDC WONDER
Keywords:
amyloidosis
cardiac amyloidosis
cardiovascular mortality
population-based study
health disparities
CDC WONDER
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