Abstract Body: Introduction: Metabolic syndrome (MS), represented by a constellation of metabolic abnormalities is a prothrombotic and proinflammatory state, known to interrupt the electrical configuration of the SA node, resulting in cardiac arrhythmia (CA). In this study we analyze the mortality trends and uncover disparities over the past 25 years (1999-2023), for patients where both MS and CA co-occur.
Methods: We analyzed CDC WONDER death-certificate data (1999–2023) for U.S. adults aged ≥25 years. Outcomes used ICD-10 codes for metabolic-syndrome components (E10–E14, E66, E78, E88, I10) and cardiac arrhythmias (I44–I49). Age-adjusted mortality rates were calculated per 100,000. Joinpoint regression estimated APC and AAPC; significance was defined as 95% CIs excluding zero (p<0.05). Forecasts used ARIMA models to project future trends.
Results: A total of 1,844,767 deaths occurred from MS and CA. AAMR started from 17.24 and rose to 24.48 in 2001 [APC: 16.85 (95% CI: 6.52 – 28.17)]. After 2001 it slowly increased to 35.96 in 2018 [APC: 1.96]. Post 2018, AAMR rose to 51.87 in 2021 [APC: 13.94] before dropping to 47.54 in 2023. Overall, there was a positive mortality trend [AAPC: 4.08 (95% CI, 3.03 – 5.14)]. Males had 48.44% deaths, with its AAMR starting from 20.09 and following the overall population’s trend before ending at 58.32 [AAPC: 4.36]. Females AAMR started from 15.02 and ended at 38.99 [AAPC: 3.79], following similar patterns. Non-Hispanic (NH) Whites with 83.01% deaths had an AAMR average of 33.46 and saw the greatest overall increase in their AAMR, starting from 16.99 and ending at 52.00 [AAPC: 4.51]. Individuals aged 65+ had the highest overall AAMR rise [AAPC: 4.37], deaths (88.28%) and AAMR average (145.44). Midwestern region had the highest AAMR average (34.68), but the region of South had the most deaths (35.51%) and the greatest overall increase [AAPC: 4.69]. Urbanization and states data, limited till 2020, revealed nonmetropolitan areas having a higher AAMR (34.64) than metropolitan ones (29.49), with the state of Vermont being affected the most with a total AAMR of 49.86, followed by Ohio (44.06) and Oregon (40.80).
Conclusions: Despite improvement in medical care, mortality remains substantial and has been steadily increasing for patients in which MS and CA co-occur, with a sharp rise occurring from 2018 till 2021. Males, NH Whites and 65+ adults and the residents of Midwest and the state of Vermont, Ohio and Oregon are disproportionately affected.