Temporal trends in ischemic heart disease mortality among lymphoma patients in the United States, 1999–2023: A 25-year nationwide analysis.

Abstract

7092 Background: Enhanced lymphoma survival has transitioned clinical priorities toward non-malignant late effects, particularly cardiovascular morbidity. Although life-extending therapies like radiation and anthracyclines are effective, their cardiotoxic profiles significantly increase Ischemic Heart Disease (IHD) risk. Despite this, longitudinal trends and demographic disparities in lymphoma-IHD mortality remain under-investigated. This study analyzes 24 years of data to characterize mortality shifts and identify vulnerable populations, aiming to optimize integrated cardio-oncology management. Methods: We conducted a population-based retrospective analysis using the CDC WONDER Multiple Cause of Death database from 1999 to 2023. Deaths among individuals with lymphoma were identified using ICD-10 codes C81–C85, and IHD-related deaths were identified using ICD-10 codes I20–I25. Age-adjusted mortality rates (AAMRs) per 100,000 persons were calculated and stratified by sex, race/ethnicity, geographic region, urbanization status, and place of death. Temporal trends were analyzed using Joinpoint regression to estimate annual percent change (APC) and average annual percent change (AAPC). Results: Between 1999 and 2023, a total of 61,480 deaths were reported among individuals with both lymphoma and IHD in the United States. The overall AAMR declined from 0.93 in 1999 to 0.62 in 2023. Females had a lower overall AAMR compared with males (0.43 vs 1.13). By race/ethnicity, Non-Hispanic individuals had a higher AAMR than Hispanic individuals (0.74 vs 0.46). Regionally, the Midwest had the highest overall AAMR (0.84), while the South had the lowest (0.64). A higher AAMR was observed in non-metropolitan compared with metropolitan areas (0.84 vs 0.69). Most deaths occurred in inpatient medical facilities (22,633 deaths; 36.8%), followed by deaths at home (18,922 deaths; 30.8%). Conclusions: While mortality has declined overall, continued excess risk among males, rural residents, and Midwestern populations highlights inequities in care delivery. Expanding integrated cardio-oncology programs in non-metropolitan areas may further reduce national mortality. Comparative analysis of age-adjusted mortality rates (AAMR) for comorbid lymphoma and ischemic heart disease by demographic and geographic subgroups (1999–2023). Category Group with Highest AAMR Group with Lowest AAMR Sex Males (1.13) Females (0.43) Ethnicity Non-Hispanic (0.74) Hispanic (0.46) Region Midwest (0.84) South (0.64) Urbanicity Non-metropolitan (0.84) Metropolitan (0.69)