JACC Adv. 2026 Jun;5(6 Pt 2):102841. doi: 10.1016/j.jacadv.2026.102841.
ABSTRACT
BACKGROUND: Contemporary trends in pulmonary embolism (PE)-attributable mortality among U.S. patients with heart failure (HF) remain underexplored.
OBJECTIVES: The objective of the study was to evaluate trends in PE-attributable mortality from 2010 to 2020 among US patients with HF, stratified by age, sex, race/ethnicity, urbanicity, and region.
METHODS: Data on PE-attributable mortality in HF patients aged ≥25 years were obtained from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database from January 2010 to December 2020. Age-adjusted mortality rates (AAMRs) were analyzed using joinpoint regression to calculate average annual percentage change with 95% CIs. Concurrent trends in HF prevalence and venous thromboembolism risk factors were assessed using the National Health and Nutrition Examination Survey data set.
RESULTS: Between 2010 and 2020, 38,129 U.S. patients with HF aged ≥25 years (17,772 men and 20,357 women) died from PE, corresponding to a proportionate mortality of 97.5 per 1,000 deaths (≈9.8%). AAMR linearly increased during this period (average annual percentage change: +4.7%; 95% CI: 3.3%-6.1%; P < 0.001), with no sex differences (P for parallelism = 0.23). The AAMR increased among individuals aged 25 to 65 years, Asian/Pacific Islanders, non-Hispanic/non-Latinx Black individuals, and residents of the Midwest. Although age-adjusted prevalence of HF plateaued overall, HF patients aged with concomitant rises in age-adjusted rates of obesity, prior smoking, atherosclerotic cardiovascular disease, chronic kidney disease, and cancer (P < 0.001 for all).
CONCLUSIONS: PE-attributable mortality among U.S. patients with HF has risen significantly over the past decade particularly among younger adults, certain ethnoracial groups, and residents of the Midwest.
PMID:42312787 | DOI:10.1016/j.jacadv.2026.102841