Trends and disparities in chronic ischemic heart disease mortality among adult cancer patients: a nationwide CDC WONDER analysis (1999-2020).

BACKGROUND: Chronic ischemic heart disease (IHD) is a leading cause of cardiovascular-related mortality worldwide, with a growing burden among cancer patients due to shared risk factors and treatment-related Cardiotoxicity. However, nationwide trends and disparities in IHD-related mortality among cancer patients remain unexplored. METHODOLOGY: This study utilized CDC WONDER mortality data from 1999 to 2020, identifying U.S. adults (≥ 25 years) with cancer (ICD-10: C00-D48) who died from chronic IHD (ICD-10: I25) as the underlying cause. Age-adjusted mortality rates (AAMRs) and annual percent changes (APCs) were calculated and stratified by gender, age, race, geographic region, and urbanization level. RESULTS: Between 1999 and 2020, there were 246,664 Chronic IHD-related deaths among adult cancer patients. The AAMR declined significantly from 8.44 per 100,000 in 1999 to 3.71 in 2020. A steady decline occurred from 1999 to 2018 (APC: -3.85%; 95% CI: -4.01 to -3.72), followed by a slight increase from 2018 to 2020 (APC: 2.92%; 95% CI: 0.33 to 4.70). Men had higher AAMRs than women (8.16 vs. 3.25). The highest CMR were observed in older adults (24.19), with significantly lower rates in middle-aged (1.26) and young adults (0.04). Racial disparities revealed the highest AAMRs in non-Hispanic Black individuals (5.64), followed by non-Hispanic Whites (5.37), NH American Indian (3.59), Hispanics (3.28), and NH Asians (2.7). Geographic trends showed that the Northeast had the highest AAMRs (6.88), while urban areas had slightly higher mortality than rural areas (5.23 vs. 5.06). CONCLUSIONS: This nationwide analysis highlights a significant decline in chronic IHD-related mortality among cancer patients, with persistent disparities by gender, age, race, and geographic location. The recent rise in AAMRs after 2018 suggests emerging risk factors that warrant further investigation. Addressing these disparities through targeted cardiovascular risk management in cancer patients is crucial to improving long-term outcomes.