{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:29:03Z","timestamp":1787754543106,"version":"build-2784847793"},"reference-count":50,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>This study evaluates national trends in heart failure (HF) and psychoactive substance abuse\u2010related mortality among adults aged 25 years and older in the United States (US) from 1999 to 2023, stratified by sex, age, race\/ethnicity, geographic regions, and the COVID\u201019 pandemic period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Data from 1999 to 2023 were extracted from the CDC WONDER database. Age\u2010adjusted mortality rates (AAMR) and annual percentage changes (APC) were calculated using Joinpoint regression. ICD\u201010 codes I50, I50.1, I50.9 (Heart Failure), and F10\u201019 (Psychoactive Substance Use) were used to identify the conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 771\u2009739 deaths were recorded from 1999 to 2023 among individuals aged 25 and older. Most deaths occurred in medical facilities (39.24%), followed by decedents' homes (34.14%), long\u2010term care facilities (16.30%), hospice (6.65%), and other settings (3.67%). The AAMR increased markedly from 1.68 in 1999 to 20.7 in 2023 (AAPC of 12.09, 95% confidence interval [CI]: 10.97\u221214.26). A substantial increase was observed from 1999 to 2005 (APC: 38.5%, 95% CI: 29.1\u201355.8), followed by a slower increase until 2020 (APC: 5.68%, 95% CI: 5.02\u201314.8). Men showed consistently higher AAMRs than females (18.8 vs. 8.65). By age group, mortality was highest among individuals aged 65 years and older.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Using CDC WONDER data (1999\u20132023), we found a sharp rise in HF mortality linked to psychoactive substance abuse, from 1.68 to 20.7 per 100\u2009000. Mortality burden was highest among males, older adults, non\u2010Hispanic White individuals, and rural populations, highlighting widening demographic and geographic disparities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/clc.70425","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T17:24:35Z","timestamp":1785173075000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Mortality Trend in Patients With Heart Failure and Psychoactive Substance Abuse in the United States\u2014Pre\u2010 and Post\u2010COVID\u201019 Pandemic Perspective (1999\u22122023)"],"prefix":"10.1002","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1365-7906","authenticated-orcid":false,"given":"Emad Uddin","family":"Sajid","sequence":"first","affiliation":[{"name":"Department of Medicine Dow University of Health Sciences Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-0546-7662","authenticated-orcid":false,"given":"Ayesha","family":"Irfan","sequence":"additional","affiliation":[{"name":"Dow Medical College DUHS Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-0984-5462","authenticated-orcid":false,"given":"Muhammad","family":"Kashan","sequence":"additional","affiliation":[{"name":"Dow Medical College DUHS Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2285-5053","authenticated-orcid":false,"given":"Syed Rayyan","family":"Ahmed","sequence":"additional","affiliation":[{"name":"Dow Medical College DUHS Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5643-0744","authenticated-orcid":false,"given":"Muhammad Hasnain","family":"Azeem","sequence":"additional","affiliation":[{"name":"Dow Medical College DUHS Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1867-943X","authenticated-orcid":false,"given":"Tooba","family":"Ali","sequence":"additional","affiliation":[{"name":"Dow University of Health Sciences Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9669-4443","authenticated-orcid":false,"given":"Mabel","family":"Waqar","sequence":"additional","affiliation":[{"name":"Department of Medicine Dow University of Health Sciences Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1601-3175","authenticated-orcid":false,"given":"Muneeba","family":"Khan","sequence":"additional","affiliation":[{"name":"Dow Institute of Cardiology DUHS Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5005-1194","authenticated-orcid":false,"given":"Erum Shahzadi","family":"Malik","sequence":"additional","affiliation":[{"name":"Dow Institute of Cardiology DUHS Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4632-5153","authenticated-orcid":false,"given":"Md Ariful","family":"Haque","sequence":"additional","affiliation":[{"name":"Voice of Doctors Research School Dhaka Bangladesh"},{"name":"Department of Public Health Atish Dipankar University of Science and Technology Dhaka Bangladesh"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,27]]},"reference":[{"key":"e_1_2_13_2_1","volume-title":"StatPearls [Internet]","author":"Shams P.","year":"2026"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000558"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.14234"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cardfail.2021.05.023"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/med.21476"},{"key":"e_1_2_13_7_1","unstructured":"\u201cMultiple Cause of Death Data on CDC WONDER [Internet] \u201d cited June 24 2026 https:\/\/wonder.cdc.gov\/mcd.html."},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/NRL.0b013e31815cffae"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2007.11.008"},{"key":"e_1_2_13_10_1","volume-title":"2013 NCHS Urban\u2010Rural Classification Scheme for Counties","author":"Ingram D. 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