Purpose: Chronic kidney disease increases the risk of acute myocardial infarction and worsens outcomes. Despite advances in care, mortality rate disparities regarding gender, race and socioeconomic status persist. This study examines trends in acute myocardial infarction-related mortality among chronic kidney disease patients in the United States from 1999 to 2020. Methods: We analyzed mortality data from the CDC WONDER database, identifying deaths with acute myocardial infarction (International Classification of Diseases, 10th Revision [ICD-10] codes I21–I22) as the underlying cause and chronic kidney disease (ICD-10 N18) as a contributing cause. Age-adjusted mortality rates per 100,000, standardized to the 2000 US population, were calculated and stratified by sex, race/ethnicity, urbanization, and state. Trends were assessed using Joinpoint regression to estimate annual percentage change with 95% confidence intervals. Results: A total of 72,780 acute myocardial infarction-related deaths in chronic kidney disease patients aged 25–85 years occurred from 1999 to 2020. The age adjusted mortality rate declined from 2.46 in 1999 to 0.99 in 2020 (annual percent change: –4.09; 95% CI –5.54 to –2.60). Men had higher mortality than women (age adjusted mortality rate: 2.11 vs. 1.13). Non-Hispanic Black individuals had the highest age adjusted mortality rate (2.90). Nonmetropolitan areas showed higher rates than metropolitan areas (1.63 vs. 1.51). A significant increase in mortality was observed among Hispanic patients from 2015 to 2020 (annual percent change: 8.15; 95% CI 1.13–15.65). Conclusions: Acute myocardial infarction-related mortality in chronic kidney disease patients has declined overall, but persistent disparities by sex, race/ethnicity, and geography highlight the need for continued efforts and targeted interventions in this high-risk population.

Background/Objectives: Despite the potential benefits, intravascular imaging for guiding percutaneous coronary intervention (PCI) remains underutilized. Recent trials have provided new data, prompting a need for updated insights. This study aimed to perform a comprehensive meta-analysis to compare the clinical outcomes of intravascular imaging-guided PCI versus angiography-guided PCI, thereby evaluating the relative effectiveness of these two guidance strategies in improving patient outcomes. Methods: PubMed, Cochrane Library, Embase and Clinicaltrials.gov databases were systematically searched from inception till 25 November 2024. Randomized clinical trials (RCTs) comparing intravascular imaging with coronary angiography in patients undergoing complex PCI were included. Statistical analysis was conducted using a random effects model to calculate pooled risk ratios with 95% confidence intervals (CI). Results: In this meta-analysis of 21 studies involving 18,043 patients, intravascular image-guided PCI significantly reduced the risk of all-cause mortality by 24%, cardiac mortality by 63%, MACE by 35%, target vessel myocardial infarction by 32%, stent thrombosis by 42%, target vessel revascularization by 45%, target lesion revascularization by 34% and myocardial infarction by 22% compared to angiography-guided PCI. There was no significant difference in bleeding events. Conclusions: Intravascular imaging significantly reduces cardiac events, all-cause mortality and revascularization rates in PCI patients. These findings support its broader adoption and potential updates to clinical guidelines.

1. The world is experiencing a dramatic increase in the incidence of hypertension, with 1.3 billion adults affected globally and 115.3 million adults affected in the United States [1,2]. Alzheimer’...