Trends in mortality and comorbidity of myelodysplastic syndromes among u.S.adults with heart failure: A CDC wonder-based analysis, 1999–2023

Abstract

Abstract Background: Myelodysplastic syndromes, a group of disorders causing ineffective hematopoiesis, leads to an increased risk of acute myeloid leukemia. Although there has been therapeutic evolution, cardiovascular conditions like Heart failure have become an increasingly important outcome for MDS patients. This makes it increasingly important to understand the epidemiological patterns of the intersection between the two conditions in order to improve outcomes. This study assesses the trends in mortality in patients within the United States from 1999-2023. Methods : We analyzed death certificates of adults aged>25' from the CDC-WONDER database with Myelodysplastic syndromes (ICD-10 codes: D46.9) and Heart failure(ICD-10 codes: I50) from 1999-2023. Age-adjusted mortality rates (AAMR) per 100,000 population were stratified by gender, race, census region, year and age. Join-Point analysis was performed to estimate annual percent change (APC) and average annual percent change (AAPC) in mortality trends, along with 95% confidence intervals (CIs). Results: Myelodysplastic syndromes and Heart failure caused 29,798 deaths in patients aged>25 years during our study period from 1999 to 2023. There was an overall surge in mortality with a change in AAMR from 0.47 in 1999 to 0.54 in 2023 . Demographically, the death rates for males increased with a change in AAMR from 0.73 to 0.82 (AAPC: 0.46; 95% CI: 0.05 to 0.88) and an overall AAMR of 0.81. Females however had a lower mortality rate as compared to males with an overall AAMR of 0.37 and a change in AAMR from 0.34 to 0.35(AAPC: 0.43; 95% CI: -0.33 to 1.20). In terms of race, mortality decreased among the Non-Hispanic (NH) Black or African Americans from 0.21 to 0.31(AAPC: 1.40; 95% CI: 0.59 to 2.22) while those among the white community decreased from 0.5 to 0.62(AAPC: 0.91; 95% CI: -0.67 to 2.51). Geographically, regions in the Midwest showed the highest overall AAMR of (0.65) followed by the West (0.56), followed by the Northeast (0.52) and the South (0.46). Among Metropolitan and Non metropolitan zones there was a slight increase in the AAMR of Non metropolitan areas (0.63) as compared to Metropolitan areas (0.52). When stratified according to states, AAMRs varied highly from the highest in North Dakota and Nevada. Conclusion: The overall mortality rates for Myodysplastic syndromes and Heart failure increased between the years 1999-2023. The highest AAMR was seen in males, regions in the Midwest, with the greatest change racially in the White community and the Non metropolitan areas.