2002 to 2016 Saw Rise in Drug Abuse-Linked Infective Endocarditis

According to a study published online Sept. 18 in the Journal of the American Heart Association, the incidence of infective endocarditis (IE) associated with drug abuse (DA) increased from 2002 to 2016 in the United States, with increases seen in all regions.

Amer N. Kadri, M.D., from the Cleveland Clinic Foundation, and colleagues describe national and geographic trends in DA-IE. Patient characteristics and outcomes were compared to those of individuals with IE without associated drug abuse.

The researchers found that between 2002 and 2016, the incidence of DA IE nearly doubled. All U.S. regions were affected, with the highest increase in DA IE hospitalizations seen in the Midwest (annual percent change, 4.9 percent). DA-IE patients were younger and more often white men, who were poorer and had fewer comorbidities; they were more likely to have HIV, hepatitis C, concomitant alcohol abuse, and liver disease. DA-IE patients had a significantly longer length of stay (nine versus seven days) and an increased likelihood of undergoing cardiac surgery (7.8 versus 6.2 percent); they also had lower inpatient mortality (6.4 versus 9.1 percent).

"Nationwide public health measures need to be implemented to address this epidemic, with targeted regional programs to specifically support patients at increased risk," a coauthor said in a statement. "Appropriately treating the cardiovascular infection is only one part of the management plan."

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