Abstract A065: Thrombosis-related trends and disparities in mortality from stroke and cardiac arrest among older adults in the United States 1999–2020: A CDC Wonder Analysis

Introduction: Stroke is a major cause of long-term disability and the fifth leading cause of death in the US, accounting for a substantial proportion of overall cardiovascular mortality. Cardiac arrest also represents a significant public health burden, being fatal in almost 90% of out-of-hospital cases. Both conditions share established risk factors, and the interplay between the two diseases worsens the prognosis. While mortality patterns for cardiac arrest and stroke have been studied separately, comprehensive national assessments of their combined trends remain scarce. This study evaluates temporal trends and demographic differences in mortality attributed to SCD and stroke among older adults in the US from 1999 to 2020 Methods: We analyzed mortality due to cardiac arrest (ICD-10 code:I46) and stroke (ICD-10 code:I60-I69), using the CDC-WONDER database from 1999 to 2023. Age-Adjusted Mortality Rates (AAMR) per 100,000 were calculated and categorized by demographics and region. Joinpoint regression was used to estimate Annual Percent Change (APC) and Average Annual Percent Change (AAPC) in AAMR. Results: A total of 541,869 deaths were attributed to cardiac arrest and stroke between 1999 and 2020. The AAMR first decreased from 94.78 in 1999 to 49.94 in 2011 (APC: -5.65; 95% CI: -6.11 to -5.19) and then declined again slightly but significantly to 47.26 in 2020 (APC: -0.84; 95% CI: -1.65 to -0.02). Men demonstrated higher AAMR than women (62.07 vs 55.98). Non-Hispanic (NH) Black individuals had the highest AAMR (94.31), followed by NH Asians (83.48), Hispanic (76.83), NH White (58.79) and NH Native Americans (38.41). Metropolitan areas had higher AAMR (60.02) than non-metropolitan areas (53.02). Stratified by census regions, the highest overall AAMR was observed in the West (92.33). Conclusion: Our study reveals that while mortality jointly attributed to cardiac arrest and stroke has declined over the past two decades, the pace of reduction has decelerated in recent years. Significant disparities remain across sex, race, ethnicity, geography, and urbanization, with higher rates in men, NH Black individuals, residents of the West and metropolitan areas. This underscores the influence of social determinants, inadequate access to healthcare services. From a clinical perspective, integrating prevention efforts for cardiac arrest and stroke through comprehensive risk factor control, early detection, and equitable access to acute care could reduce the combined burden.