Abstract
Background: Cardiac arrest and malignant arrhythmias are major contributors to mortality in patients with plasma cell disorders. Understanding temporal mortality trends in this group is critical for evaluating the impact of evolving therapies and guiding preventive strategies.
Objective: To examine national trends and temporal changes in age-adjusted mortality rates due to cardiac arrest, ventricular fibrillation, and ventricular flutter among individuals diagnosed with plasma cell disorders in the United States from 2018-2023 using the CDC WONDER database.
Methods: A retrospective, population-based analysis was conducted using publicly available CDC WONDER mortality data from 2018 through 2023. Mortality rates attributable to cardiac arrest (ICD-10 I46.x, I49.0) and plasma cell disorders (ICD-10 C90.x) were identified. Age-adjusted mortality rates per 100,000 population were calculated for males, females, and the overall population. Joinpoint regression analysis was performed to estimate annual percent change (APC), average annual percent change (AAPC), and determine statistically significant inflection points.
Results: Over the study period from 2018 to 2023, overall age-adjusted mortality rates from cardiac arrest and malignant ventricular arrhythmias among patients with plasma cell disorders declined from 0.3 to 0.2 per 100,000 population, with an APC of 7.8% per year. Joinpoint analysis revealed no statistically significant inflection points, indicating a gradual and consistent downward trend. Among males, mortality declined from 0.4 to 0.3 per 100,000 (APC: 5.6%), with the steepest, though non-significant, drop between 2018 and 2020 (APC: 13.4%). In females, mortality remained stable at 0.2 per 100,000 throughout the study period (APC: 0.0%), with no joinpoints detected. Mortality rates in males were consistently higher than in females. While the overall decline may reflect improvements in cardiovascular and oncologic care, low event rates and the limited 6-year time frame reduce the ability to detect subtle or short-term changes as statistically significant.
Conclusion:
From 2018 to 2023, cardiac arrest, ventricular fibrillation, and ventricular flutter mortality rates in patients with plasma cell disorders declined in the US, with no significant inflection points observed. This analysis suggests a modest and consistent decline, particularly among males and the overall cohort, while mortality rates in females remained low and unchanged. The absence of significant inflection points suggests gradual improvements, likely driven by advances in both cardiovascular and hematologic care through early screening and interventions. Persistently higher mortality rates in males underscore the need for sex-specific risk assessment and management strategies. These findings provide a national overview, emphasize the need for ongoing surveillance, and can guide future research and clinical management strategies for cardiovascular risk mitigation in this population.
