{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T19:25:37Z","timestamp":1790623537104,"version":"4.1.0"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,12,14]],"date-time":"2021-12-14T00:00:00Z","timestamp":1639440000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2021,12,14]],"date-time":"2021-12-14T00:00:00Z","timestamp":1639440000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Treatment options for several chronic infectious and inflammatory conditions have expanded in recent years. This may have implications for evolving competing risks for chronic inflammation-associated comorbidities, including cardiovascular diseases (CVDs). Yet sparse data exist on patterns over time in cardiovascular mortality for chronic infectious and inflammatory conditions. We used data from the Centers for Disease Control and Prevention 1999\u20132018 Multiple Causes of Death database to investigate patterns in CVD mortality from January 1, 1999 to December 31, 2018 in several infectious and inflammatory conditions. Specifically, we determined age-adjusted proportionate CVD mortality separately for patients with the following conditions (as well as the general population): hepatitis C virus (HCV), human immunodeficiency virus (HIV), inflammatory bowel diseases (IBD), psoriasis (PSO), rheumatoid arthritis (RA), and systemic lupus erythematosus (SLE). Proportionate CVD mortality differed significantly in 1999 and 2018 for each condition compared with the general population (p\u2009&lt;\u20090.0001). Proportionate CVD mortality decreased steadily in the general population (40.9 to 30.6%) but increased for patients with HCV (7.0 to 10.2%) and HIV (1.9 to 6.7%). For IBD, PSO, RA, and SLE, proportionate CVD mortality initially decreased followed by plateauing or increasing rates. Underlying disease-specific pathophysiologies, changes in natural history, and competing risks of chronic end-organ diseases contributing to these differences merit further study.<\/jats:p>","DOI":"10.1038\/s41598-021-03407-4","type":"journal-article","created":{"date-parts":[[2021,12,14]],"date-time":"2021-12-14T11:03:55Z","timestamp":1639479835000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Changes in proportionate cardiovascular mortality in patients with chronic infectious and inflammatory conditions in the United States, 1999\u20132018"],"prefix":"10.1038","volume":"11","author":[{"given":"Jacob W.","family":"Groenendyk","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adovich S.","family":"Rivera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arjun","family":"Sinha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donald M.","family":"Lloyd-Jones","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew J.","family":"Feinstein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,12,14]]},"reference":[{"key":"3407_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1056\/NEJMp1916753","volume":"383","author":"AS Fauci","year":"2020","unstructured":"Fauci, A. S. & Lane, H. C. Four decades of HIV\/AIDS\u2014Much accomplished, much to do. N. Engl. J. Med. 383, 1\u20134. https:\/\/doi.org\/10.1056\/NEJMp1916753 (2020).","journal-title":"N. Engl. J. Med."},{"key":"3407_CR2","doi-asserted-by":"publisher","first-page":"1453","DOI":"10.1016\/s0140-6736(18)32111-1","volume":"393","author":"F Carrat","year":"2019","unstructured":"Carrat, F. et al. Clinical outcomes in patients with chronic hepatitis C after direct-acting antiviral treatment: A prospective cohort study. Lancet 393, 1453\u20131464. https:\/\/doi.org\/10.1016\/s0140-6736(18)32111-1 (2019).","journal-title":"Lancet"},{"key":"3407_CR3","doi-asserted-by":"publisher","first-page":"489","DOI":"10.1016\/j.jchf.2019.11.013","volume":"8","author":"S Prasada","year":"2020","unstructured":"Prasada, S. et al. Differential associations of chronic inflammatory diseases with incident heart failure. JACC Heart Fail. 8, 489\u2013498. https:\/\/doi.org\/10.1016\/j.jchf.2019.11.013 (2020).","journal-title":"JACC Heart Fail."},{"key":"3407_CR4","doi-asserted-by":"publisher","first-page":"214","DOI":"10.1016\/j.amjcard.2015.10.030","volume":"117","author":"MJ Feinstein","year":"2016","unstructured":"Feinstein, M. J. et al. Patterns of cardiovascular mortality for HIV-infected adults in the United States: 1999 to 2013. Am. J. Cardiol. 117, 214\u2013220. https:\/\/doi.org\/10.1016\/j.amjcard.2015.10.030 (2016).","journal-title":"Am. J. Cardiol."},{"key":"3407_CR5","doi-asserted-by":"publisher","first-page":"741","DOI":"10.1038\/ajg.2011.63","volume":"106","author":"AJ Yarur","year":"2011","unstructured":"Yarur, A. J. et al. Inflammatory bowel disease is associated with an increased incidence of cardiovascular events. Off. J. Am. Coll. Gastroenterol. ACG 106, 741\u2013747. https:\/\/doi.org\/10.1038\/ajg.2011.63 (2011).","journal-title":"Off. J. Am. Coll. Gastroenterol. ACG"},{"key":"3407_CR6","doi-asserted-by":"publisher","first-page":"837","DOI":"10.1161\/circulationaha.114.009990","volume":"130","author":"A Dregan","year":"2014","unstructured":"Dregan, A., Charlton, J., Chowienczyk, P. & Gulliford, M. C. Chronic inflammatory disorders and risk of type 2 diabetes mellitus, coronary heart disease, and stroke: A population-based cohort study. Circulation 130, 837\u2013844. https:\/\/doi.org\/10.1161\/circulationaha.114.009990 (2014).","journal-title":"Circulation"},{"key":"3407_CR7","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1007\/s11883-015-0557-y","volume":"18","author":"H Teague","year":"2016","unstructured":"Teague, H. & Mehta, N. N. The link between inflammatory disorders and coronary heart disease: A look at recent studies and novel drugs in development. Curr. Atheroscler. Rep. 18, 3. https:\/\/doi.org\/10.1007\/s11883-015-0557-y (2016).","journal-title":"Curr. Atheroscler. Rep."},{"key":"3407_CR8","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1097\/qai.0000000000001495","volume":"76","author":"A Satcher Johnson","year":"2017","unstructured":"Satcher Johnson, A., Song, R. & Hall, H. I. Estimated HIV incidence, prevalence, and undiagnosed infections in US States and Washington, DC, 2010\u20132014. J. Acquir. Immune Defic. Syndr. 76, 116\u2013122. https:\/\/doi.org\/10.1097\/qai.0000000000001495 (2017).","journal-title":"J. Acquir. Immune Defic. Syndr."},{"key":"3407_CR9","doi-asserted-by":"publisher","first-page":"1020","DOI":"10.1002\/hep.30297","volume":"69","author":"MG Hofmeister","year":"2019","unstructured":"Hofmeister, M. G. et al. Estimating prevalence of hepatitis C virus infection in the United States, 2013\u20132016. Hepatology 69, 1020\u20131031. https:\/\/doi.org\/10.1002\/hep.30297 (2019).","journal-title":"Hepatology"},{"key":"3407_CR10","doi-asserted-by":"publisher","first-page":"777","DOI":"10.7326\/M17-0102","volume":"167","author":"EY Yen","year":"2017","unstructured":"Yen, E. Y. et al. 46-year trends in systemic lupus erythematosus mortality in the United States, 1968 to 2013: A nationwide population-based study. Ann. Intern. Med. 167, 777\u2013785. https:\/\/doi.org\/10.7326\/M17-0102 (2017).","journal-title":"Ann. Intern. Med."},{"key":"3407_CR11","first-page":"704","volume":"12","author":"EV Loftus Jr","year":"2016","unstructured":"Loftus, E. V. Jr. Update on the incidence and prevalence of inflammatory bowel disease in the United States. Gastroenterol. Hepatol. (N. Y.) 12, 704\u2013707 (2016).","journal-title":"Gastroenterol. Hepatol. (N. Y.)"},{"key":"3407_CR12","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1097\/bor.0000000000000480","volume":"30","author":"G Stojan","year":"2018","unstructured":"Stojan, G. & Petri, M. Epidemiology of systemic lupus erythematosus: An update. Curr. Opin. Rheumatol. 30, 144\u2013150. https:\/\/doi.org\/10.1097\/bor.0000000000000480 (2018).","journal-title":"Curr. Opin. Rheumatol."},{"key":"3407_CR13","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.jaad.2016.07.064","volume":"76","author":"J Takeshita","year":"2017","unstructured":"Takeshita, J. et al. Psoriasis and comorbid diseases: Epidemiology. J. Am. Acad. Dermatol. 76, 377\u2013390. https:\/\/doi.org\/10.1016\/j.jaad.2016.07.064 (2017).","journal-title":"J. Am. Acad. Dermatol."},{"key":"3407_CR14","doi-asserted-by":"publisher","first-page":"270","DOI":"10.1016\/j.cjca.2018.11.029","volume":"35","author":"A Sinha","year":"2019","unstructured":"Sinha, A. & Feinstein, M. J. Coronary artery disease manifestations in HIV: What, how, and why. Can. J. Cardiol. 35, 270\u2013279. https:\/\/doi.org\/10.1016\/j.cjca.2018.11.029 (2019).","journal-title":"Can. J. Cardiol."},{"key":"3407_CR15","doi-asserted-by":"publisher","first-page":"326","DOI":"10.1136\/annrheumdis-2014-205675","volume":"74","author":"A Ogdie","year":"2015","unstructured":"Ogdie, A. et al. Risk of major cardiovascular events in patients with psoriatic arthritis, psoriasis and rheumatoid arthritis: A population-based cohort study. Ann. Rheum. Dis. 74, 326\u2013332. https:\/\/doi.org\/10.1136\/annrheumdis-2014-205675 (2015).","journal-title":"Ann. Rheum. Dis."},{"key":"3407_CR16","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1016\/j.semarthrit.2012.12.002","volume":"43","author":"SR Schoenfeld","year":"2013","unstructured":"Schoenfeld, S. R., Kasturi, S. & Costenbader, K. H. The epidemiology of atherosclerotic cardiovascular disease among patients with SLE: A systematic review. Semin. Arthritis Rheum. 43, 77\u201395. https:\/\/doi.org\/10.1016\/j.semarthrit.2012.12.002 (2013).","journal-title":"Semin. Arthritis Rheum."},{"key":"3407_CR17","doi-asserted-by":"publisher","first-page":"1000","DOI":"10.1093\/eurheartj\/ehp567","volume":"31","author":"NN Mehta","year":"2010","unstructured":"Mehta, N. N. et al. Patients with severe psoriasis are at increased risk of cardiovascular mortality: Cohort study using the General Practice Research Database. Eur. Heart J. 31, 1000\u20131006. https:\/\/doi.org\/10.1093\/eurheartj\/ehp567 (2010).","journal-title":"Eur. Heart J."},{"key":"3407_CR18","doi-asserted-by":"publisher","first-page":"1400","DOI":"10.1002\/art.40930","volume":"71","author":"M Aringer","year":"2019","unstructured":"Aringer, M. et al. 2019 European League Against Rheumatism\/American College of Rheumatology Classification Criteria for Systemic Lupus Erythematosus. Arthritis Rheumatol. (Hoboken, N.J.) 71, 1400\u20131412. https:\/\/doi.org\/10.1002\/art.40930 (2019).","journal-title":"Arthritis Rheumatol. (Hoboken, N.J.)"},{"key":"3407_CR19","doi-asserted-by":"publisher","first-page":"2283","DOI":"10.1056\/NEJMoa062360","volume":"355","author":"The Strategies for Management of Antiretroviral Therapy (SMART) Study Group","year":"2006","unstructured":"The Strategies for Management of Antiretroviral Therapy (SMART) Study Group. CD4+ count-guided interruption of antiretroviral treatment. N. Engl. J. Med. 355, 2283\u20132296. https:\/\/doi.org\/10.1056\/NEJMoa062360 (2006).","journal-title":"N. Engl. J. Med."},{"key":"3407_CR20","doi-asserted-by":"publisher","first-page":"795","DOI":"10.1056\/NEJMoa1506816","volume":"373","author":"The INSIGHT START Study Group","year":"2006","unstructured":"The INSIGHT START Study Group. Initiation of antiretroviral therapy in early asymptomatic HIV infection. N. Engl. J. Med. 373, 795\u2013807. https:\/\/doi.org\/10.1056\/NEJMoa1506816 (2015).","journal-title":"N. Engl. J. Med."},{"key":"3407_CR21","doi-asserted-by":"publisher","first-page":"e98","DOI":"10.1161\/CIR.0000000000000695","volume":"140","author":"MJ Feinstein","year":"2019","unstructured":"Feinstein, M. J. et al. Characteristics, prevention, and management of cardiovascular disease in people living with HIV: A scientific statement from the American Heart Association. Circulation 140, e98\u2013e124. https:\/\/doi.org\/10.1161\/CIR.0000000000000695 (2019).","journal-title":"Circulation"},{"key":"3407_CR22","doi-asserted-by":"publisher","first-page":"998","DOI":"10.1111\/jvh.12725","volume":"24","author":"O Osibogun","year":"2017","unstructured":"Osibogun, O. et al. HIV\/HCV coinfection and the risk of cardiovascular disease: A meta-analysis. J. Viral. Hepat. 24, 998\u20131004. https:\/\/doi.org\/10.1111\/jvh.12725 (2017).","journal-title":"J. Viral. Hepat."},{"key":"3407_CR23","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.120.019144","volume":"9","author":"E Mandieka","year":"2020","unstructured":"Mandieka, E., Saleh, D., Chokshi, A. K., Rivera, A. S. & Feinstein, M. J. Latent tuberculosis infection and elevated incidence of hypertension. J. Am. Heart Assoc. 9, e019144. https:\/\/doi.org\/10.1161\/JAHA.120.019144 (2020).","journal-title":"J. Am. Heart Assoc."},{"key":"3407_CR24","doi-asserted-by":"publisher","first-page":"936","DOI":"10.2105\/ajph.2011.300544","volume":"102","author":"N Krieger","year":"2012","unstructured":"Krieger, N. Methods for the scientific study of discrimination and health: An ecosocial approach. Am. J. Public Health 102, 936\u2013944. https:\/\/doi.org\/10.2105\/ajph.2011.300544 (2012).","journal-title":"Am. J. Public Health"},{"key":"3407_CR25","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1016\/j.ahj.2018.11.012","volume":"209","author":"RA Riestenberg","year":"2019","unstructured":"Riestenberg, R. A. et al. Differences in statin utilization and lipid lowering by race, ethnicity, and HIV status in a real-world cohort of persons with human immunodeficiency virus and uninfected persons. Am. Heart J. 209, 79\u201387. https:\/\/doi.org\/10.1016\/j.ahj.2018.11.012 (2019).","journal-title":"Am. Heart J."},{"key":"3407_CR26","doi-asserted-by":"publisher","first-page":"1147","DOI":"10.1007\/s40615-016-0320-2","volume":"4","author":"J Jung","year":"2017","unstructured":"Jung, J. & Feldman, R. Racial-ethnic disparities in uptake of new hepatitis C drugs in medicare. J. Racial Ethn. Health Dispar. 4, 1147\u20131158. https:\/\/doi.org\/10.1007\/s40615-016-0320-2 (2017).","journal-title":"J. Racial Ethn. Health Dispar."},{"key":"3407_CR27","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m2688","volume":"370","author":"NS Shah","year":"2020","unstructured":"Shah, N. S. et al. Heterogeneous trends in burden of heart disease mortality by subtypes in the United States, 1999\u20132018: Observational analysis of vital statistics. BMJ 370, m2688. https:\/\/doi.org\/10.1136\/bmj.m2688 (2020).","journal-title":"BMJ"},{"key":"3407_CR28","doi-asserted-by":"publisher","first-page":"1011","DOI":"10.1097\/01.mlr.0000228018.48783.34","volume":"44","author":"T Henderson","year":"2006","unstructured":"Henderson, T., Shepheard, J. & Sundararajan, V. Quality of diagnosis and procedure coding in ICD-10 administrative data. Med. Care 44, 1011\u20131019. https:\/\/doi.org\/10.1097\/01.mlr.0000228018.48783.34 (2006).","journal-title":"Med. Care"},{"key":"3407_CR29","doi-asserted-by":"publisher","first-page":"1186","DOI":"10.1093\/rheumatology\/keh717","volume":"44","author":"J Calvo-Al\u00e9n","year":"2005","unstructured":"Calvo-Al\u00e9n, J. et al. Lack of recording of systemic lupus erythematosus in the death certificates of lupus patients. Rheumatology (Oxford) 44, 1186\u20131189. https:\/\/doi.org\/10.1093\/rheumatology\/keh717 (2005).","journal-title":"Rheumatology (Oxford)"},{"key":"3407_CR30","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1186\/s12891-015-0727-7","volume":"16","author":"E Molina","year":"2015","unstructured":"Molina, E., del Rincon, I., Restrepo, J. F., Battafarano, D. F. & Escalante, A. Mortality in Rheumatoid Arthritis (RA): Factors associated with recording RA on death certificates. BMC Musculoskelet. Disord. 16, 277\u2013277. https:\/\/doi.org\/10.1186\/s12891-015-0727-7 (2015).","journal-title":"BMC Musculoskelet. Disord."},{"key":"3407_CR31","doi-asserted-by":"publisher","first-page":"E04","DOI":"10.5888\/pcd12.140299","volume":"12","author":"P Ong","year":"2015","unstructured":"Ong, P. et al. Effect of cause-of-death training on agreement between hospital discharge diagnoses and cause of death reported, inpatient hospital deaths, New York City, 2008\u20132010. Prev. Chronic Dis. 12, E04\u2013E04. https:\/\/doi.org\/10.5888\/pcd12.140299 (2015).","journal-title":"Prev. Chronic Dis."},{"key":"3407_CR32","unstructured":"CDC WONDER: Multiple Cause of Death 1999\u20132019. https:\/\/wonder.cdc.gov\/wonder\/help\/mcd.html#Age-Adjusted%20Rates. Accessed January 30 2021."},{"key":"3407_CR33","first-page":"1","volume":"47","author":"RN Anderson","year":"1998","unstructured":"Anderson, R. N. & Rosenberg, H. Age standardization of death rates: Implementation of the year 2000 standard. Natl. Vital Stat. Rep. 47, 1\u201316 (1998).","journal-title":"Natl. Vital Stat. Rep."},{"key":"3407_CR34","unstructured":"R: A language and environment for statistical computing, https:\/\/www.R-project.org\/ (2021). Accessed January 30 2021."},{"key":"3407_CR35","doi-asserted-by":"crossref","unstructured":"Wickham H. ggplot2: Elegant Graphics for Data Analysis. (Springer-Verlag New York, 2016).","DOI":"10.1007\/978-3-319-24277-4"},{"key":"3407_CR36","first-page":"20","volume":"8","author":"V Muggeo","year":"2008","unstructured":"Muggeo, V. Segmented: An R package to fit regression models with broken-line relationships. R News 8, 20\u201325 (2008).","journal-title":"R News"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-03407-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-03407-4","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-03407-4.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,3]],"date-time":"2022-12-03T18:01:11Z","timestamp":1670090471000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-021-03407-4"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,14]]},"references-count":36,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,12]]}},"alternative-id":["3407"],"URL":"https:\/\/doi.org\/10.1038\/s41598-021-03407-4","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,14]]},"assertion":[{"value":"20 July 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 November 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 December 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"DLJ serves as current president of the American Heart Association. All other authors declare no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"23985"}}