BACKGROUND: Dilated cardiomyopathy (DCM) is a significant contributor to heart failure and sudden cardiac death in the United States. Understanding mortality trends associated with DCM is crucial to inform healthcare strategies and policy interventions to mitigate its burden. OBJECTIVES: This study aimed to assess temporal trends in DCM-related mortality in the United States from 1999 to 2020, including an analysis of age-adjusted mortality rates (AAMRs), annual percent changes (APCs), and disparities across gender, racial/ethnic, geographic, and urbanization categories. METHODS: A retrospective observational study was conducted using data from the CDC WONDER database. DCM-related mortality was identified using the ICD-10 code I42.0. The study population included individuals in the United States with DCM listed as a contributing or primary cause of death from 1999 to 2020. AAMRs were calculated and standardized to the U.S. 2000 standard population. Joinpoint regression analysis was used to evaluate trends and calculate APCs and subgroup analyses were conducted to assess disparities. RESULTS: From 1999 to 2020, 168 702 deaths were attributed to DCM. The overall AAMR declined significantly from 9.33 per 100 000 individuals in 1999 to 6.61 in 2020 (APC: -3.43%, 95% CI: -4.09 to -2.70
CONCLUSIONS: While DCM-related mortality declined significantly, persistent gender, racial, and regional disparities highlight the need for targeted interventions. The evolving role of heart transplantation and LVADs underscores the importance of equitable access to advanced therapies to reduce DCM-related mortality further.