Valvular heart disease vs. coronary artery disease: a comparative mortality analysis of long-term outcomes using CDC WONDER (1999-2020)

Document Type

Conference Proceeding

Publication Date

11-5-2025

Publication Title

Eur Heart J

Keywords

adult, Alaska, Black person, case fatality rate, Caucasian, conference abstract, controlled study, coronary artery disease, epidemiology, ethnicity, female, heart disease, human, major clinical study, male, metropolitan area, mortality, mortality rate, New Mexico, New York, United States, urbanization, valvular heart disease

Abstract

Introduction: Valvular heart disease (VHD) occurs when one or more heart valves-mitral, aortic, tricuspid, or pulmonary-are damaged or defective, affecting over 5 million people in the U.S. and causing about 25,000 deaths annually. Coronary artery disease (CAD), often found in VHD patients, is caused by fatty deposits narrowing the arteries, reducing blood flow to the heart. As the most common heart disease worldwide, CAD led to 371,506 deaths in the U.S. in 2022 and affects 1 in 20 adults aged 20 and older. Objective: This study examines mortality trends of Valvular Heart Disease and Coronary Artery Disease over a period of two decades. Method: This study analyzes U.S. deaths from Valvular Heart Disease (VHD) and Coronary Artery Disease (CAD) from 1999 to 2020 using CDC WONDER. Mortality data were identified using ICD codes for VHD (I34-I39), CAD (I25.1-I25.9). Age-adjusted mortality rates (AAMRs) and annual percentage change (APC) with 95% confidence intervals were assessed by sex, race/ethnicity, and region using joinpoint analysis. Results: From 1999-2020, total deaths due to VHD and CAD were 376576 and 4511997 respectively with an overall decrease in mortality rate. In 2020, the mortality rate among males was high for both VHD and CAD. However, the mortality rate for CAD was significantly higher than for VHD, with an age-adjusted mortality rate (AAMR) of 1777.027 for CAD compared to 133.67 for VHD. Our analysis also revealed higher overall mortality trends in the 65+ age group for both VHD and CAD, with an AAMR of 377.73 for VHD and 4282.31 for CAD. Overall, the NH Whites exhibited the highest mortality rates for VHD (AAMR= 159.55; 95% Cl: 159.01 - 160.09). In contrast, NH Blacks showed the highest mortality trend among CAD patients (AAMR= 1811.09; 95% Cl: 1805.39 - 1816.79). The Midwest region exhibited the highest overall mortality rate for VHD and CAD patients (VHD APC: -3.16; 95% Cl: -3.90 to -2.47) and (CAD APC: -0.87; 95% Cl: -2.16 to 1.13). Regarding urbanization, VHD-related mortality was higher in non-metropolitan areas, with an AAMR of 154.40, whereas metropolitan areas had a higher mortality rate for CAD, with an AAMR of 1758.65.In terms of states, the highest mortality rate for VHD was observed in Oregon, while the lowest was in New Mexico. For CAD, New York recorded the highest mortality rate, whereas the lowest was seen in Alaska. Conclusion: Overall mortality rates for VHD and CAD declined from 1999 to 2020, significant disparities persist. CAD mortality remained notably higher than VHD, particularly among males and older adults. NH Whites had the highest VHD mortality, whereas NH Blacks had the highest for CAD. Regional and urbanization differences were evident, with the Midwest and metropolitan areas showing higher CAD mortality, while VHD mortality was more prominent in non-metropolitan areas. State-level variations further highlight the need for targeted interventions.

Volume

46

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