Background/Purpose: This study aimed to analyze two decades of consecutive mortality data to investigate cardiovascular deaths in Systemic Lupus Erythematosus (SLE) across the United States (US), identifying patterns and disparities in mortality rates.

Methods: A retrospective analysis was conducted using mortality data from the CDC WONDER database spanning 1999-2020. ICD-10 codes (I00-I99) for diseases of the circulatory system and (M32) for SLE were used to identify cardiovascular-related deaths in SLE among adults aged 25 years and older at the time of death. Age-adjusted mortality rates (AAMRs) per 100,000 persons were calculated, and trends were assessed using Average Annual Percentage Change (AAPC) and Annual Percent Change (APC). Data were stratified by year, sex, race/ethnicity, and geographical regions.

Results: Between 1999 and 2020, cardiovascular-related deaths in SLE accounted for 6,548 deaths among adults aged 25 and older in the US. The overall AAMR for cardiovascular-related deaths in SLE decreased from 1.81 in 1999 to 1.53 in 2020, with an AAPC of -0.9963 (95% CI: -1.908 to 0.2433, p=0.025). A significant decline occurred from 1999 to 2014 (APC: -3.19; 95% CI: -5.56 to -2.17), followed by a notable increase from 2014 to 2020 (APC: 4.73; 95% CI: 0.407 to 18.29). Women exhibited higher AAMRs compared to men (women: 2.12, men: 0.53). The AAMR for both men and women decreased, with a steeper decline for men from 1999 to 2014 (APC: -4.85) compared to women in the same period (APC: -2.81). African Americans or Blacks had the highest AAMRs (3.54), followed by American Indians or Alaska Natives (1.6), Whites (1.12), and Asian/Pacific Islanders (1.02). The highest mortality was in the Western region (AAMR: 1.6). Geographically, AAMRs ranged from 0.62 in Massachusetts to 3.1 in Oklahoma. Metropolitan areas had higher AAMRs than non-metropolitan areas (1.41 vs. 1.29), with a significant decrease in non-metropolitan areas (AAPC: -1.0407, p=0.00639) and non-significant decrease in metropolitan areas (AAPC: -0.8617, p=0.1519).

Conclusion: This analysis highlights notable differences in mortality rates related to cardiovascular deaths in SLE. The target population was adult patients aged 25 and above in the United States. These results are based on demographic and geographic factors. Initially, there was a considerable decrease, but recently the mortality rates have started to rise. This underscores the importance of focused interventions to address disparities and improve health outcomes.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/trends-and-disparities-in-cardiovascular-deaths-in-systemic-lupus-erythematosus-a-population-based-retrospective-study-in-the-united-states-from-1999-to-2021/