Abstract 4369029: Regional and Temporal Mortality Trends of Congenital Cardiovascular Malformations in Patients with Chromosomal Abnormalities in the United States from 1999 to 2020
Siddiqi, AK; Ur Rehman, O; Jamil, A; Nadeem, Z; Ali, KM; NAEEM, M; Hardin, J; Rodriguez, F; Thaler, C; Book, W; De Cecco, C; Krasuski, R
Published in: Circulation
Congenital cardiovascular malformations (CVMs) affect 0.5 to 0.7% of all live born infants. Chromosomal abnormalities (CA) both increase CVM severity and contribute to higher mortality, yet their regional and temporal mortality patterns remain poorly characterized.
This study aimed to analyze 1999-2020 mortality trends, comparing CVM patients with and without CA to identify disparities.
The CDC WONDER dataset was used to derive crude (CMR) and age-adjusted mortality rates (AAMR) per 1,000,000 population, stratified by year, gender, race, and region. We identified CVM-related deaths using ICD-10 codes Q20-Q28 and CAs-related deaths using ICD-10 codes Q90-Q99. Average annual percentage changes (AAPC) were assessed by Joinpoint regression.
117,837 CVM-related deaths occurred over 2+ decades, with 10% (12,049) involving co-existing CA. AAMRs steadily declined over time in patients without coexisting CA (AAPC: -1.9) but remained unchanged in patients with CA (AAPC: -1, p < 0.001). Females having CVM with CA had a slightly higher AAMR (2.21) as compared to males (1.59). Hispanics or Latino patients with coexisting CA had higher AAMR (1.90) as compared to non-Hispanics (1.85). Infants having CVM with CA displayed the highest AAMR (100.64) with a decline in mortality during the study period (AAPC = -0.40, p < 0.05), whereas deaths declined across all age groups. Mortality rates were higher in rural areas, the Midwest, and states with fewer accredited adult congenital heart disease centers (Figure).
CVM mortality steadily declined in patients without CA but remained unchanged in those with CA in the last two decades. These results may help optimize public health policy.
