ArticleBMC cardiovascular disorders2025
Temporal trends and disparities in cardiovascular disease-related mortality among adults with multiple myeloma in the United States, 1999-2023.
Article in BMC cardiovascular disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Editorial: introducing special collection on cancer and cardiovascular disorders.BMC cardiovascular disorders · 2026Article
- Trends in liver failure-related mortality among middle-aged and older adults with digestive system malignant tumors in the United States, 1999-2023.Frontiers in oncology · 2026Article
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3 authors.
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Abstract
backgroundNovel therapeutic agents have substantially improved multiple myeloma (MM) survival, making cardiovascular disease (CVD) a predominant cause of non-cancer mortality. Because MM predominantly affects older adults (median age 69 years) at elevated cardiovascular risk, we focused on adults aged ≥ 45 years. Comprehensive national data on temporal trends and demographic disparities in CVD-related mortality among MM patients remain limited.
methodsWe conducted a retrospective analysis using CDC WONDER Multiple Cause-of-Death database data (1999-2023) for U.S. adults aged ≥ 45 years with MM and CVD as underlying or contributing causes of death. Age-adjusted mortality rates (AAMRs) per 100,000 population were standardized to the 2000 U.S. standard population using the direct method. Joinpoint regression analysis identified temporal changepoints and calculated annual percent changes (APCs) and average annual percent changes (AAPCs).
resultsAmong 117,907 CVD-related deaths in MM patients, overall AAMR was 3.92 per 100,000 (95% CI: 3.80-4.03) with no significant long-term change (AAPC + 0.04%). Joinpoint analysis revealed five phases: non-significant increase from 1999 to 2001 (APC + 3.10%), significant decline from 2001 to 2009 (APC - 2.05%), stability from 2009 to 2018 (APC + 0.16%), marked increase from 2018 to 2021 (APC + 6.70%, P < 0.05), and significant decline from 2021 to 2023 (APC - 4.59%). Males had significantly higher mortality than females (5.23 vs. 2.98 per 100,000; P < 0.001). Non-Hispanic Black adults experienced highest burden (8.38 per 100,000), 2.4-fold higher than non-Hispanic White adults (3.51 per 100,000). Mortality increased significantly with age (P < 0.001 for trend), reaching 18.46 per 100,000 in adults ≥ 85 years. Hypertensive diseases (AAPC + 4.79%) and cardiac arrhythmias (AAPC + 3.71%) showed largest increases, while ischemic heart diseases (AAPC - 1.15%) and cerebrovascular diseases (AAPC - 1.07%) declined. Geographic analysis revealed the highest mortality rates in the Northeast (4.29 per 100,000) and West (4.14 per 100,000).
conclusionsAlthough overall CVD mortality remained stable over 25 years, concerning increases in hypertensive, arrhythmic, thromboembolic, and heart failure mortality during 2018-2021 coincided with expanded cardiotoxic therapy use and COVID-19 disruptions. These findings highlight the importance of incorporating baseline cardiovascular risk assessment and longitudinal surveillance into MM treatment pathways, ensuring adherence to guideline-based thromboprophylaxis, and developing multidisciplinary cardio-oncology models that address persistent racial and ethnic disparities in cardiovascular outcomes.
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