Shifting burden of cardiomyopathy deaths among United States cancer patients: A 25-year CDC WONDER analysis.

Abstract

e24009 Background: Cardiomyopathies (CM) are increasingly recognized among patients with cancer. They may develop due to the direct effects of the tumor, side effects of cancer treatments, or other underlying health conditions. These disorders can cause heart failure, abnormal heart rhythms, and impact overall well-being. Recognizing and managing cardiomyopathies in cancer patients is crucial for improving treatment outcomes and survival. Methods: We analyzed CDC WONDER data to estimate age-adjusted mortality rates (AAMRs) for cancer (ICD-10: C00-D48) among adults aged ≥25 years with cardiomyopathies (ICD-10 I42.0 to I42.9). AAMRs were calculated per 100,000 population. Temporal trends and average annual percent changes (AAPCs) were assessed using Joinpoint regression, stratified by sex, race/ethnicity, and geographic factors, including urbanization and U.S. census region. Results: A total of 58,583 deaths related to CM among cancer patients were identified, with most deaths occurring in medical facility inpatient settings. Overall, the AAMR declined from 1.21 in 1999 to 0.97 in 2023 (AAPC: −0.87; 95% CI: −1.25 to −0.49). A modest decline was observed between 1999 and 2008 (APC: −0.65), followed by a more pronounced decrease through 2016 (APC: −3.31). However, mortality rates showed significant increase from 2016 through 2023 (APC: 1.69; 95% CI: 0.83 to 2.56). The decline in mortality was more pronounced among men than women (AAPC: −1.46 vs. −0.54). Among racial and ethnic groups, the highest mortality burden was observed in Non-Hispanic Black individuals (AAPC: −2.17%), while the lowest decline was noted among Hispanic or Latino individuals (AAPC: −1.80%). Geographic disparities were evident, with the Midwest experiencing the greatest mortality burden (AAPC: −0.54%), whereas the West showed the least impact (AAPC: −1.33%). Non- metropolitan areas consistently showed higher AAMRs than metropolitan areas, although metropolitan regions experienced a slightly steeper decline over time (AAPC: −1.36 vs. −1.15). Conclusions: CM remains a significant cause of death among patients with cancer, with higher burden observed in men, non-Hispanic Black individuals, and those living in the Midwest. Although mortality rates declined overall, a recent increase was noted, which highlight the need for focused cardio-oncology care and targeted prevention strategies for high-risk populations. Deaths and Average Annual Percentage Change (AAPC) per 100,000 population for Cardiomyopathy and cancer trends, 1999-2023. Variable Deaths AAPC (95%CI) Overall 58,583 -0.87 (-.25 to 1.75) Male 35,243 -1.46 (-2.41 to -0.50) Female 23,340 -0.53 (-1.04 to -0.02) NH Blacks 8,048 -2.17 (-2.58 to -1.77) Hispanic 2,576 -1.80 (-2 50 to -1.11) Midwest 15,176 -0.54 (-1.37 to 0.29) West 11,309 -1.33 (-1.75 to -0.91) Metropolitan 41,531 -1.36 areas (-2.05 to -0.72) Non- Metropolitan areas 9,006 -1.55 (-1.66 to -0.64)