Mortality from myocardial infarction in GI malignancy from 1999 to 2020.

Abstract

e16332 Background: Cancer patients are at higher risk of myocardial infarction. Malignancy creates conditions that increase the risk of coronary thrombosis, even in patients without classic atherosclerosis. In addition, myocardial infarction can be an adverse effect of certain chemotherapies. Recent research suggests that gastrointestinal cancers are one of the malignancies that place patients at highest risk for myocardial infarction. Examining mortality trends is critical for understanding how effective our approach to this has been over time. Methods: This retrospective study uses the CDC WONDER database, which contains national mortality data, to analyze trends in acute myocardial infarction mortality in patients with known history of gastrointestinal cancer. This was done using ICD-10 codes of C15-26 for GI cancers and I21 for acute myocardial infarction. Mortality data was analyzed across different demographic subgroups in the United States from 1999 to 2020 to assess for trends. Age-adjusted mortality rates (AAMRs) per 100,000 individuals were calculated and further stratified based on sex and race. Results: A total of 42,776 deaths from myocardial infarction were recorded in patients with GI cancers from 1999 to 2020. Overall AAMR decreased consistently from 1999 (0.961) to 2015 (0.389), then plateaued til 2019 (0.396), and then increased in 2020 (0.446). Men consistently had higher AAMRs than women, although there were decreases in both sexes during this time period. Men’s AAMR fell from 1.450 in 1999 to 0.649 in 2020, while women ’s AAMR fell from 0.633 in 1999 to 0.274 in 2020. The AAMR decrease over time was also seen across all races. In non-Hispanic Whites, it fell from 0.939 in 1999 to 0.434 in 2020. For African Americans, it was 1.32 in 1999 and 0.463 in 2020; for Hispanics, 0.729 in 1999 and 0.503 in 2020. Lastly, for AAPI, 0.432 in 1999 and 0.385 in 2020. Conclusions: Our analysis shows that the mortality rate from acute MI in patients with GI cancers has decreased over time. However, there are still significant racial and gender disparities in mortality that can be improved upon. Men continue to have notably higher mortality rates than women, with this disparity continuing over these two decades even as both of their mortality rates have fallen. Hispanic Americans and African Americans have higher mortality rates than non-Hispanic White Americans and Asian Americans/Pacific Islanders, although the difference has decreased over these two decades. While there is great progress that has been made, things can still be improved in this area. Age adjusted mortality rate (AAMR) per 100,000 from 1999 to 2020 for myocardial infarction in patients with gastrointestinal cancers. Group AAMR per 100,000 in 1999 AAMR per 100,00 in 2020 All 0.961 0.446 Men 1.450 0.649 Women 0.633 0.274 White Americans 0.939 0.434 African American 1.32 0.463 Hispanic Americans 0.729 0.503 Asian Americans/Pacific Islanders 0.432 0.385