Pulmonary Embolism Mortality Rising Among Patients With ASCVD, suggests research
Deaths attributable to pulmonary embolism (PE) among patients with atherosclerotic cardiovascular disease (ASCVD) increased in the United States between 2010 and 2023. The rise was particularly pronounced among young and middle-aged adults, racial and ethnic minority groups, and people living in the Western region, highlighting the need for improved risk assessment, early diagnosis, and timely treatment. The study was published in the Journal of the American Heart Association by Marco Z. and colleagues.
To explore temporal trends and demographic differences in mortality due to PE in those with pre-existing ASCVD, researchers carried out a retrospective nationwide study based on the CDC WONDER mortality database from 2010 to 2023. The patient cohort included 152,386 US patients aged 15 years and above with a history of ASCVD who died of PE.
Age-adjusted mortality rates (AAMRs) per 100,000 people were calculated and analyzed using Joinpoint regression models in order to determine the average annual percentage change (AAPC) for age, sex, race, ethnicity, urban or rural residence, and geographic census region. At the same time, trends in age-adjusted ASCVD prevalence and metabolic risk factors were examined across waves of national surveys using NHANES linear modeling.
Key findings:
- Extensive analyses conducted among 152,386 US patients with ASCVD deaths attributable to PE (80,015 men, 72,371 women) revealed clear temporal trends and demographic differences.
- Over the period from 2010 to 2023, the overall PE-attributable AAMR in patients with ASCVD increased from 3.62 to 4.96 per 100,000 people (annual percentage change +3.1%; P < 0.001) with a mild initial increase from 2010 to 2018 (+0.7% per year, P = 0.003) followed by a dramatic increase from 2018 to 2023 (+12.8% per year, P < 0.001).
- The highest overall AAMR was observed among non-Hispanic/non-Latinx Black Americans, while American Indian/Alaska Native and Hispanic/Latinx populations demonstrated the most significant mortality increases.
- Young adults aged less than 65 years, rural residents, and the Western part of the country demonstrated disproportionate mortality increases, while the Southern region demonstrated the highest number of deaths.
- Increase in PE mortality closely followed the prevalence of ASCVD in the whole nation due to increasing rates of hypertension, obesity, diabetes mellitus, and chronic kidney disease.
In summary, data from a 14-year national registry reveal a significant increase in deaths caused by pulmonary embolism in US adults with atherosclerotic cardiovascular disease. The study’s conclusions highlight the fact that this increase is particularly higher among younger adults, people living in rural settings, and disadvantaged racial/ethnic minorities.
Reference:
Zuin, M., Bilato, C., Rigatelli, G., Goldhaber, S., & Piazza, G. (2026). Pulmonary embolism‐attributable mortality in patients with atherosclerotic cardiovascular disease in the United States from 2010 to 2023. Journal of the American Heart Association, 15(20), e049510. https://doi.org/10.1161/jaha.126.049510
