Endocarditis Rates Rise Significantly Due to the Opioid Epidemic

Rates of drug abuse-related infective endocarditis (DA-IE) have risen sharply in the US in response to the national opioid epidemic, according to the results of a recent study.

To track the geographical distribution and incidence of DA-IE, researchers conducted a study of patients with ICD-9 and ICD-10­–defined IE in the United States using data from the National Inpatient Sample registry from 2002-2016. The nearly 1 million hospitalized patients were compared with patients who presented with IE that was not related to drug abuse.

Over the 14 years studied, the incidence of DA-IE nearly doubled, with all regions of the US being affected and with the Midwest having the highest increases (annual percent change 4.9%). Those with DA-IE were younger, at lower economic status, and had fewer comorbidities than those with IE from other causes and were most commonly white males. They were also more likely to have HIV, hepatitis C, concomitant alcohol abuse, and liver disease. Their hospital stays were longer (9 vs 7 days) and were more likely to undergo cardiac surgery (7.8% vs 6.2%), although their inpatients mortality was lower (6.4% vs 9.1%).

“Appropriately treating the cardiovascular infection is only one part of the management plan. Helping these patients address their addictive behaviors with social supports and effective rehabilitation programs is central to improving their health and preventing drug abuse relapses,” said senior author Serge C. Harb, M.D., assistant professor of medicine at Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, in an accompanying press release.

—Michael Potts

References:

Kadri AN, Wilner B, Hernandez AV, et al. Geographic trends, patient characteristics, and outcomes of infective endocarditis associated with drug abuse in the United States From 2002 to 2016 [published online September 18, 2019].

Alarming number of heart infections tied to opioid epidemic [press release]. Dallas, Texas. September 18, 2019. https://newsroom.heart.org/news/alarming-number-of-heart-infections-tied-to-opioid-epidemic?preview=880d.