Temporal trends and disparities in sudden cardiac death among pancreatic cancer patients in the United States.

Abstract

e16438 Background: In patients with pancreatic cancer, sudden cardiac death (SCD) is an overlooked terminal event. There is an absence of population-level data characterizing its burden and disparities. We looked at national trends as well as regional and demographic differences in SCD among Americans who died from pancreatic cancer. Methods: The CDC WONDER Multiple Cause of Death database (1999–2020) was examined. ICD-10 code C25 was used to identify deaths from pancreatic cancer as the underlying cause of death. Contributing cause codes I46.1, I46.9, I49.0, I21 to I24, R96, and R96.1 were used to define SCD. Descriptive analyses were carried out to measure the mortality burden and its distribution by age, sex, race, and state. The 2000 U.S. population was used to standardize age-adjusted mortality rates (AAMRs). Results: Among those who died from pancreatic cancer, 34,489 deaths were linked to SCD. The crude mortality rate was 3.17 per 100,000, with a range of 0.1 to 12.2 and a median of 1.8. The burden of SCD rose with age, reaching a peak among those between the ages of 75 and 84, while those between the ages of 25 and 34 had the fewest deaths. SCD-associated mortality was consistently higher in men than in women. There were clear racial differences: White decedents had significantly lower rates, while Black or African American decedents had the highest AAMRs, followed by Asian or Pacific Islander people. There was noticeable regional variation: the highest average AAMRs were found in New York, California, Mississippi, Georgia, and Connecticut, while the lowest were found in Illinois, Michigan, Texas, North Carolina, and Pennsylvania. Although disparities remained across demographic and geographic strata, overall SCD-associated mortality showed a declining temporal pattern. Conclusions: Among people who die from pancreatic cancer, sudden cardiac death is a substantial and unevenly distributed factor in mortality. Persistent disparities by age, sex, race, and state indicate an increased focus on cardiovascular risk assessment, cardio-oncology integration, and end-of-life cardiac monitoring in this high-risk population. Descriptive characteristics of sudden cardiac death among pancreatic cancer decedents, united states, 1999–2020. Characteristic Deaths, n (%) Total sudden cardiac death–associated deaths 34,489 (100) Sex Male Higher proportion Female Lower proportion Age Group (years) 25–34 Lowest 35–44 Low 45–54 Moderate 55–64 Increased 65–74 High 75–84 Highest ≥85 Slightly lower than 75–84 Race White Lower burden Black or African American Highest burden Asian or Pacific Islander Elevated American Indian/Alaska Native Variable / sparse State-Level Mortality (Mean Age-Adjusted Rates) Highest-burden states New York Highest California High Mississippi High Georgia High Connecticut High Lowest-burden states Illinois Lowest Michigan Low Texas Low North Carolina Low Pennsylvania Low