Fewer heart failure patients are dying from cardiac arrest—but disparities persist
U.S. patients are significantly less likely to die from heart failure-related cardiac arrest now than they were 25 years ago, according to new data published in the American Journal of Cardiology.[1] However, the authors noted, certain disparities still exist, suggesting cardiologists and other healthcare providers have much more work to do.
“Heart failure currently affects over 64 million adults worldwide, with about 6 million impacted in the United States, a number expected to rise to 8 million by 2030, wrote corresponding author Sivaram Neppala, MD, an assistant professor with the cardiology division at The University of Texas Health Sciences Center, and colleagues. “Patients diagnosed with heart failure face a significantly higher risk of cardiac arrest, contributing to 30-50% of mortality cases within this population. Those with systolic dysfunction are six to nine times more likely to experience sudden cardiac death. Cardiac arrest and heart failure can lead to irregular heart rhythms and myocardial fibrosis, increasing the risk of ventricular arrhythmias and highlighting the need for urgent care.”
Neppala et al. explored U.S. Centers for Disease Control and Prevention data from 1999 to 2023, tracking changes in the overall age-adjusted mortality rate (AAMR) for cardiac arrest in patients with heart failure. All patients included in their analysis were 25 years old or older.
Overall, the researchers found that the AAMR for heart failure-related cardiac arrest dropped from 25.3 per 100,000 adults in 1999 to 20.6 in 2023. The reduction was the most pronounced from 1999 to 2011, with an annual percentage change of -2.95%, but then remained largely unchanged from 2011 to 2018. The overall AAMR then increased from 2018 to 2021—a time when the COVID-19 pandemic was at its most severe—before dropping yet again from 2021 to 2023.
“The subsequent decline from 2021 to 2023 (APC: -4.05%) indicates recovery and improved access to healthcare, highlighting the pandemic's effects on cardiovascular outcomes and the necessity for resilient healthcare systems,” the authors wrote.
Tracking healthcare disparities in cardiac arrest mortality
The research revealed several notable disparities between different patient groups in terms of heart failure-related cardiac arrest mortality. The reduction from 1999 to 2023, for example, was more significant for women (22.6 to 16.2) than it was for men (29.5 to 26.2).
In addition, certain ethic/racial groups were associated with a higher AAMR than others. The overall AAMRs from 1999 to 2023 were 28.8 per 100,000 adults for Black patients, 22.8 for Hispanic/Latino patients, 19.5 for white patients and 18.1 for all other racial/ethnic categories.
Rural areas were also linked to a notably higher overall AAMR (20.9) than urban areas (20.1). This represents a known trend in the United States; cardiologists and other clinicians have been working for years to improve care for rural patients.
“The rising mortality rates from cardiac arrest among heart failure patients, particularly affecting men, Black individuals, and those residing in rural areas, require our urgent attention,” the authors concluded. “We can reduce disparities and improve patient outcomes by implementing targeted interventions and enhancing healthcare access.”
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Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.