From the 8th International Cancer Congress

Background: Ischemic heart disease (IHD) is a leading cause of death in the United States, and death certificates may contain medical or surgical care-related codes among decedents with IHD. However, these codes do not establish procedural exposure, postoperative status, timing, or causality. This study assesses 25-year trends in mortality involving IHD and Y83–Y84 codes. Methods: Nationwide multiple-cause-of-death (MCOD) death-certificate records were obtained from the CDC WONDER database for U.S. adults aged ≥25 years from 1999–2023. Death records containing IHD (ICD-10 codes I20–I25) and medical/surgical care-related codes (Y83–Y84) were identified. We calculated age-adjusted mortality rates (AAMRs) per 100,000 people in the general U.S. population. We used joinpoint regression to estimate annual percentage changes (APCs) and average annual percentage changes (AAPCs). Results: From 1999–2023, a total of 144,644 deaths were reported. The AAMR significantly decreased from 4.19 in 1999 to 1.13 in 2023 (AAPC: -5.51; p = 0.000021). The overall AAMR was 3.78 (AAPC: −5.26) among males and 1.71 (AAPC: −6.12) among females. By race, AAMRs declined substantially among all groups from 1999 to 2023, with the highest 1999 AAMR observed among NH White individuals (4.35). Regionally, the Midwest had the highest overall AAMR (2.75). Adults aged ≥65 years had the highest overall CMR (10.34). From 1999 to 2020, the population-level AAMR was 3.21 in nonmetropolitan areas and 2.45 in metropolitan areas. Conclusion: Mortality involving IHD and medical/surgical procedure-related codes declined in recent years, particularly during 2021–2023. Higher population-level mortality rates were observed among males and in the Midwest region.