Among adults with cancer, chronic ischemic heart disease (IHD) remains an important contributor to cardiovascular-related mortality, with variation across demographic and geographic groups. In Cardio-Oncology, a nationwide mortality analysis evaluated long-term trends in chronic IHD-related deaths among U.S. adults with cancer.

Using Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research mortality data from 1999 to 2020, the observational study identified adults aged 25 years or older with cancer, defined by International Classification of Diseases, Tenth Revision codes C00–D48. Chronic IHD (code I25) was recorded as the underlying cause of death. Age-adjusted mortality rates (AAMRs) and annual percent changes (APCs) were calculated. Analyses were stratified by sex, age, race, geographic region, and urbanization level.

Between 1999 and 2020, 246,664 chronic IHD-related deaths occurred among adult cancer patients. AAMRs declined from 8.44 per 100,000 in 1999 to 3.71 in 2020. From 1999 to 2018, mortality decreased steadily (APC, −3.85%; 95% CI, −4.01 to −3.72). From 2018 to 2020, rates increased modestly (APC, 2.92%; 95% CI, 0.33 to 4.70).

Mortality rates were higher in men than women (8.16 vs 3.25). Older adults had the highest crude mortality rate (24.19), compared with middle-aged adults (1.26) and younger adults (0.04). AAMRs were highest among NH Black individuals, followed by NH White, NH American Indian, Hispanic, and NH Asian populations. The Northeast region showed the highest rates. Urban areas had slightly higher mortality than rural areas.

The analysis showed a long-term decline in chronic IHD-related mortality among cancer patients, with persistent disparities and a recent increase after 2018.