Temporal trends in mortality from 1999 to 2020 in patients aged over 25 years with heart failure and cardiogenic shock

Background: Heart failure (HF) is a major cause of mortality and its association with cardiogenic shock (CS) remains underexplored. Understanding this relationship is essential to identify high-risk populations and develop targeted public health interventions. Aim was to evaluate mortality trends in HF, where CS is a contributing cause of death by using the Centers for Diseases Control and Prevention (CDC) multiple causes of death by (MCD) database. Methods: A retrospective original research study was conducted using the CDC MCD database to assess mortality trends between 1999 and 2020 in individuals >25 years in the United States. Deaths from congestive HF (ICD-10, I50.0), left ventricular failure (i50.1) and HF, unspecified (ICD-10, I50.9) as underlying cause and CS (ICD-10, R57.0) as contributor cause were selected. Data were stratified by gender, race, geographic region and place of death. Age-adjusted mortality rates (AAMR) and annual percentage change (APC) were calculated. Results: A total of 14901 deaths were recorded. The AAMR for HF with CS showed a decline from 1999 to 2009 (APC- -4.84%), an increase, 2009 - 2012 (APC +3.92%) and decline, 2012 to 2020 (APC: 2.68%) with the highest mortality observed in males (56.6%), white individuals (76.7%), and metropolitan areas (81.50%). Trends showed an increase in AAMR in females (APC: +15.48 %) after 2012, black individuals with APC +22.10% after 2010 demonstrating disparities. Conclusions: Mortality trends in HF have changed with rising disparities in gender and race, indicating need for cardiac interventions and improved health care access.