Clinical cardiology · 2026
Trends and Disparities in Acute Myocardial Infarction-Related Mortality With Co-Listed Nicotine Dependence in the United States, 1999-2020.
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Cheema Asad Ali Ahmed, Gulzar Abu Huraira Bin, Zehra Mishal, Cheema Ayesha Ahmed, Saleem Ayesha, Jalal Sayed Mohammad Saud, Shafi Nimra, Arshad Mirza Ammar, Raza Kinza, Magsi Iffat Ambreen
Аннотация
BACKGROUND: Nicotine use is a major modifiable risk factor for acute myocardial infarction (AMI), yet national mortality patterns involving co-listed nicotine dependence remain under-characterized.
METHODS: Using CDC WONDER Multiple Cause of Death data from 1999 to 2020, we evaluated AMI-related mortality among US adults aged ≥ 25 years with co-listed death-certificate-coded nicotine dependence, operationally defined using ICD-10 F17.0-F17.9. AMI was identified using ICD-10 I21.0-I22.9. Age-adjusted mortality rates (AAMRs) per 100 000 population were calculated using the 2000 US standard population. Temporal trends were assessed using Joinpoint regression and stratified by sex, age, race/ethnicity, region, urbanization, state, and place of death.
RESULTS: From 1999 to 2020, 357 167 AMI-related deaths with co-listed nicotine dependence occurred among adults aged ≥ 25 years. The AAMR increased from 1.64 to 9.46 per 100 000 population (average annual percent change, 10.27%; p < 0.001). Men had higher AAMRs than women (11.30 vs. 4.27), with significant increases in both groups. Mortality increased with age, highest among adults aged ≥ 85 years (33.55) and lowest among those aged 35-44 years (0.83). Non-Hispanic American Indian/Alaska Native adults had the highest AAMR (10.30). Rates were higher in the Midwest and South, nonmetropolitan areas exceeded metropolitan areas, and the highest state-level AAMRs occurred in North Dakota and Wyoming. Most deaths occurred in inpatient facilities or at home.
CONCLUSION: AMI-related mortality with co-listed nicotine dependence increased substantially from 1999 to 2020, with persistent demographic and geographic disparities. These findings may inform targeted tobacco-control, nicotine-cessation, and cardiovascular prevention strategies for high-risk populations over time.
METHODS: Using CDC WONDER Multiple Cause of Death data from 1999 to 2020, we evaluated AMI-related mortality among US adults aged ≥ 25 years with co-listed death-certificate-coded nicotine dependence, operationally defined using ICD-10 F17.0-F17.9. AMI was identified using ICD-10 I21.0-I22.9. Age-adjusted mortality rates (AAMRs) per 100 000 population were calculated using the 2000 US standard population. Temporal trends were assessed using Joinpoint regression and stratified by sex, age, race/ethnicity, region, urbanization, state, and place of death.
RESULTS: From 1999 to 2020, 357 167 AMI-related deaths with co-listed nicotine dependence occurred among adults aged ≥ 25 years. The AAMR increased from 1.64 to 9.46 per 100 000 population (average annual percent change, 10.27%; p < 0.001). Men had higher AAMRs than women (11.30 vs. 4.27), with significant increases in both groups. Mortality increased with age, highest among adults aged ≥ 85 years (33.55) and lowest among those aged 35-44 years (0.83). Non-Hispanic American Indian/Alaska Native adults had the highest AAMR (10.30). Rates were higher in the Midwest and South, nonmetropolitan areas exceeded metropolitan areas, and the highest state-level AAMRs occurred in North Dakota and Wyoming. Most deaths occurred in inpatient facilities or at home.
CONCLUSION: AMI-related mortality with co-listed nicotine dependence increased substantially from 1999 to 2020, with persistent demographic and geographic disparities. These findings may inform targeted tobacco-control, nicotine-cessation, and cardiovascular prevention strategies for high-risk populations over time.