Demographic and regional trends in multiple myeloma and cardiovascular disease–related mortality among adults age 35 and older in the United States from 1999 to 2020: A CDC WONDER analysis.

Abstract

e19565 Background: Approximately 7.5% of patients with multiple myeloma encounter cardiovascular diseases. Despite the substantial prevalence and established correlation, no study has ever investigated trends across various demographics in the United States. This study analyzed mortality trends and disparities among adults aged 35 and older from 1999to 2020. Methods: Using ICD-10 Codes: C90.0 and I00-I99, we extracted data from the CDC-WONDER from 1999 to 2020. We calculated the Annual Percentage Changes (APC) with a 95% confidence interval and Age-Adjusted Mortality Rate (AAMR) per 100,000 individuals, stratifying them by gender, age, race, urbanization, census region, and place of death. Results: A total of 99570 deaths were reported throughout the study period. The overall AAMR rose from 2.82 in 1999 to 2.94 in 2020, with an average annual percent change (AAPC) of 0.19 (p=0.198). A significantly rising trend in mortality was observed during the last two years, from 2018 to 2020, with an average APC of 7.11 (95% CI: 2.45-9.70; p < 0.000001). Men had higher AAMRs than women (3.54 vs. 2.04) and a greater rate of increase (AAPC: 0.52, p< 0.000001). AAMRs varied among racial groups, with non-Hispanic (NH) Black having the highest AAMR (5.74), followed by Hispanics (2.44), NH Whites (2.42), NH Americans (2.38) and NH Asian (1.54). NH Black experienced the steepest increase from 2018 to 2020 (APC: 10.31, p=. 0.039). The Northeast had the highest regional AAMR (2.98) followed by the West (2.81), South (2.53) and Midwest (2.44). Rural areas reported the highest AAMR (2.68) (AAPC: 0.09, p= 0.587). The District of Columbia had the highest state AAMR (3.90). The highest number of deaths occurred in medical facilities (48.68%). The age group 75-84 years showed the highest percentage of deaths (36.26%), while the 85+ age group had the highest crude mortality rate (AAPC: 0.63, p= 0.0012). Conclusions: Our analysis revealed a consistent rise in mortalities during the last three years. This calls for urgent targeted public interventions. Discrepancies across age, gender, and race call for future research to identify the root causes of these variations. Variable Variable Deaths (n) Total AAMR (95% CI) Deaths (n) Total AAMR (95% CI) Overall 99570 2.66 (2.64 to 2.67) Urbanization Sex Urban 82325 2.68 (2.66 to 2.70)  Female 43928 2.04 (2.02 to 2.06) Rural 17245 2.62 (2.58 to 2.66)  Male 55642 3.54 (3.51 to 3.57) Race/Ethnicity Census Region NH American Indians 453 2.38 (2.15 to 2.61)  Northeast 21855 2.98 (2.94 to 3.01) NH Asians 2210 1.54 (1.48 to 1.61)  Midwest 20674 2.44 (2.41 to 2.47) NH Blacks 19349 5.74 (5.66 to 5.83)  South 34575 2.53 (2.50 to 2.55) NH White 72179 2.42 (2.40 to 2.44)  West 22466 2.81 (2.77 to 2.85) Hispanics 6659 2.44 (2.38 to 2.50)