Ann Vasc Surg. 2026 Apr 2:S0890-5096(26)00221-9. doi: 10.1016/j.avsg.2026.03.051. Online ahead of print.
ABSTRACT
INTRODUCTION: Aortic stenosis (AS) and coronary artery disease (CAD) frequently coexist in older adults due to shared risk factors and overlapping pathophysiologic mechanisms. Despite substantial advances in surgical and transcatheter therapies, national mortality trends in patients with concurrent AS and CAD remain incompletely defined.
METHODS: Using the CDC WONDER database, we analyzed U.S. mortality records from 1999-2024 for adults aged ≥65 years in whom AS (I35.0) and CAD (I20-I25) were listed as an underlying or contributing cause of death. Age-adjusted mortality rates (AAMRs) per 100,000 population were calculated, and temporal trends were assessed with Joinpoint regression to estimate Annual Percentage Changes (APCs) and Average Annual Percent Changes (AAPCs) across demographic and geographic subgroups.
RESULTS: From 1999-2024, 215,647 deaths were recorded, with overall AAMR changing from 21.48 to 17.90. Males had higher AAMRs than females (26.32 vs. 12.15 in 2024). By race and ethnicity, the highest rates in 2024 occurred among non-Hispanic (NH) White populations (20.84), followed by Hispanic or Latino (9.67), NH Black or African American (8.54), and NH Asian or Pacific Islander populations (6). Regionally, the highest mortality in 2024 was observed in the Midwest (20.40), followed by the West (19.14), Northeast (18.08), and South (15.68).
CONCLUSION: Despite an overall decline, AS- and CAD-related mortality remains substantial, with persistent sex, racial, and geographic disparities. These findings highlight an urgent need for improved early detection, optimized management of concomitant AS and CAD, and expanded access to specialized cardiac care in underserved regions.
PMID:41935825 | DOI:10.1016/j.avsg.2026.03.051