Abstract WE484: Mortality From Coexisting Metabolic Syndrome and Cardiac Arrhythmias Increased in the United States From 1999 to 2023

Abstract

Introduction: Metabolic syndrome (MS), represented by a constellation of metabolic abnormalities is a prothrombotic and proinflammatory state, known to interrupt the electrical configuration of the SA node, resulting in cardiac arrhythmia (CA) . In this study we analyze the mortality trends and uncover disparities over the past 25 years (1999-2023), for patients where both MS and CA co-occur. Methods: We analyzed CDC WONDER death-certificate data (1999–2023) for U.S. adults aged ≥25 years. Outcomes used ICD-10 codes for metabolic-syndrome components (E10–E14, E66, E78, E88, I10) and cardiac arrhythmias (I44–I49). Age-adjusted mortality rates were calculated per 100,000. Joinpoint regression estimated APC and AAPC; significance was defined as 95% CIs excluding zero (p<0.05). Forecasts used ARIMA models to project future trends. Results: A total of 1,844,767 deaths occurred from MS and CA. AAMR started from 17.24 and rose to 24.48 in 2001 [APC: 16.85 (95% CI: 6.52 – 28.17)]. After 2001 it slowly increased to 35.96 in 2018 [APC: 1.96]. Post 2018, AAMR rose to 51.87 in 2021 [APC: 13.94] before dropping to 47.54 in 2023. Overall, there was a positive mortality trend [AAPC: 4.08 (95% CI, 3.03 – 5.14)]. Males had 48.44% deaths, with its AAMR starting from 20.09 and following the overall population’s trend before ending at 58.32 [AAPC: 4.36]. Females AAMR started from 15.02 and ended at 38.99 [AAPC: 3.79], following similar patterns. Non-Hispanic (NH) Whites with 83.01% deaths had an AAMR average of 33.46 and saw the greatest overall increase in their AAMR, starting from 16.99 and ending at 52.00 [AAPC: 4.51]. Individuals aged 65+ had the highest overall AAMR rise [AAPC: 4.37], deaths (88.28%) and AAMR average (145.44). Midwestern region had the highest AAMR average (34.68), but the region of South had the most deaths (35.51%) and the greatest overall increase [AAPC: 4.69]. Urbanization and states data, limited till 2020, revealed nonmetropolitan areas having a higher AAMR (34.64) than metropolitan ones (29.49), with the state of Vermont being affected the most with a total AAMR of 49.86, followed by Ohio (44.06) and Oregon (40.80). Conclusions: Despite improvement in medical care, mortality remains substantial and has been steadily increasing for patients in which MS and CA co-occur, with a sharp rise occurring from 2018 till 2021. Males, NH Whites and 65+ adults and the residents of Midwest and the state of Vermont, Ohio and Oregon are disproportionately affected.