Trends in Mortality Among Adults With Acute Myocardial Infarction With Cardiogenic Shock in the United States, 1999-2023

Background: Cardiogenic shock (CS) elevates mortality rates among patients with acute myocardial infarction (AMI), yet there are insufficient data on trends in mortality. This study seeks to elucidate demographic patterns and mortality statistics. Methods: We analyzed data from the Centers for Disease Control and Prevention's Wide-ranging ONline Data for Epidemiologic Research (1999-2023) to evaluate mortality related to CS among AMI patients aged 25 years and above. Age-adjusted mortality rates (AAMR) per 100,000 patients and average annual percentage changes were calculated using JoinPoint regression analysis to explore mortality trends. Results: Cardiogenic shock contributed to 187,838 deaths among AMI patients aged 25 years and older. Between 1999 and 2023, the AAMR fell from 5.4 to 3.3 per 100,000, reflecting an average annual percentage change of –2.02. The most significant reduction occurred from 1999 to 2011, followed by a notable increase from 2011 to 2021 (annual percent change, 3.32). Disparities are apparent, as men have higher AAMR than women (4.5 vs 2.5), with Hispanic individuals at the most significant risk (AAMR, 3.5), followed by Whites (AAMR, 3.4). Regionally, West Virginia has the highest AAMR at 5.3, whereas Minnesota has the lowest at 2.3. Additionally, rural areas report higher AAMR than urban ones (4.0 vs 3.2). Conclusions: The recent increase in mortality rates between 2011 and 2021 due to CS in AMI and disparities among men, Hispanic individuals, and people living in rural areas—calls for urgent attention. By applying focused interventions and improving health care access, we can bridge these gaps and enhance patient outcomes.