The findings, published in JAMA Health Forum, reveal a continuing and worrying trend in worsening US mortality compared to other wealthy nations over the last four decades. While excess deaths per year peaked at the height of the COVID-19 pandemic in 2021, excess deaths in 2023 still far exceeded prepandemic levels in 2019 and closely matched the rising pre-pandemic trend. After rising steadily since 1980, excess US deaths reached 1,098,808 in 2021, before dropping to 820,396 in 2022 and 705,331 in 2023, after the acute phase of the pandemic. However, the 2023 figure was still tens of thousands of deaths higher than the 2019 total of 631,247 missing Americans.

Researchers have found that prescribing guideline-directed medical treatment (GDMT), regardless of the number of medications, can improve survival rates in patients 90 years of age and older following their first heart attack, with the greatest benefit observed in patients who received all four recommended post-acute myocardial infarction (AMI) therapies. These include beta-blockers, antiplatelets, lipid-lowering drugs, and renin-angiotensin-aldosterone system inhibitors. The findings of the article appearing in the Canadian Journal of Cardiology, published by Elsevier, can guide future clinical approaches to managing first-onset AMI in nonagenarians and centenarians.