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Trends of Pulmonary Embolism-Related Sudden Cardiac Death in the United States, 1999–2019

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Abstract

Objectives

Up-to-date population-based data on pulmonary embolism (PE)-related sudden cardiac death (SCD) mortality trends in the United States (US) are scant. We assess the current trends in PE-related SCD mortality in US over the past two decades and determine differences by sex, race, ethnicity, age, and census region.

Methods

We extracted PE-related SCD mortality rates from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER) database from 1999 to 2019, in patients aged ≥ 15 years old. Age‐adjusted mortality rates (AAMRs) were assessed using the Joinpoint regression modeling and expressed as estimated average annual percentage change (AAPC) with relative 95% confidence intervals (CIs).

Results

Between 1999 and 2019, the AAMR from acute PE-related SCD mortality in the US linearly increased [AAPC: +2.4% (95% CI: 2.2 to 2.6), p < 0.001)]. The AAMR increase was more pronounced in men [AAPC: +2.8% (95% CI: 2.6 to 2.9), p < 0.001], Whites [AAPC: +2.7% (95% CI: 2.3 to 3.1), p < 0.001], Latinx/Hispanic patients [AAPC:+2.0% (95% CI: 1.2 to 2.8), p < 0.001], subjects younger than 65 years [AAPC: +2.4% (95% CI: 2.1 to 2.6), p < 0.001] and in residents of rural areas [AAPC: +3.6% (95% CI: 3.3 to 3.9), p < 0.001]. Moreover, higher percentages of PE-related SCD and the relative absolute number of deaths were observed in the South compared with other geographical regions.

Conclusions

PE-related SCD mortality in the US has increased over the last two decades. Stratification by race, ethnicity, urbanization, and census region demonstrates ethnoracial and regional disparities that require further investigation and remedy.

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Data availability

The data underlying this article are freely available from the CDC WONDER dataset at https://wonder.cdc.gov/mcd.html.

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Authors and Affiliations

  1. Department of Translational Medicine, University of Ferrara, Via Aldo Moro 8, Ferrara, 44124, Italy

    Marco Zuin

  2. Department of Clinical Pharmacology, Aalborg University Hospital, Aalborg, Denmark

    Thure Filskov Overvad

  3. Department of Otolaryngology, Head and Neck Surgery and Audiology, Aalborg University Hospital, Aalborg, Denmark

    Ida Ehlers Albertsen

  4. Department of Cardiology, West Vicenza Hospital, Arzignano, Italy

    Claudio Bilato

  5. Cardiovascular Medicine Division and Thrombosis Research Group, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Gregory Piazza

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Contributions

MZ and GP conceptualization and design. MZ and CB data collection and analysis. MZ wrote the first draft of the manuscript. All the authors contributed to the interpretation of data, revised the manuscript critically, and approved the final manuscript.

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Correspondence to Marco Zuin.

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Conflict of interest

GP received research support from Bristol-Myers Squibb/Pfizer Alliance, Bayer, Janssen, Alexion, Amgen and Boston Scientific Corporation, and consulting fees from Pfizer, Boston Scientific Corporation, Janssen, and Amgen. The other authors have no conflicts of interest to declare.

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Zuin, M., Overvad, T.F., Albertsen, I.E. et al. Trends of Pulmonary Embolism-Related Sudden Cardiac Death in the United States, 1999–2019. J Thromb Thrombolysis 57, 483–491 (2024). https://doi.org/10.1007/s11239-024-02946-7

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