Trends and Disparities in CAD and AMI in the United States From 2000 to 2020.

Background: Coronary artery disease (CAD) and acute myocardial infarction (AMI) still pose a significant burden to the health care system, affecting population subgroups differently.

Objectives: The purpose of the study was to describe age, sex, and racial disparities in mortality rates for CAD and AMI in the United States between 2000 and 2020.

Methods: This was an ecological study with trend analysis of mortality rates using data from the National Centers for Disease Control and Prevention surveillance databases.

Results: Between 2000 and 2020, there was a significant decrease in the age-standardized mortality rates of both CAD (from 249.4 to 118 per 100,000 cases [ < 0.001]) and AMI (from 93.4 to 34.1 per 100,000 cases [ < 0.001]), with deceleration in the decline of mortality rates after 2011. CAD and AMI mortality rates were both significantly higher in males ( < 0.001), the 75+ years age group ( < 0.001), and in non-Hispanic Blacks (NHBs) and non-Hispanic Whites (NHWs) compared to Hispanics ( < 0.001). While CAD mortality rates were higher in NHB compared to NHW ( = 0.037), there was no significant difference in AMI mortality rates between NHB and NHW ( = 0.144). There was also no difference in both CAD and AMI mortality rates between the 25 to 44 years and 45 to 64 years age groups ( = 0.051 and  = 0.072).

Conclusions: While a significant reduction in mortality rates is evident, the notable deceleration in this decline in recent years reflects a plateauing of earlier gains and highlights the need to identify new targets. The persistent disparities in the identified population subgroups necessitate further exploration to inform targeted interventions and policies.