Opioid abuse linked to dangerous heart infection

In a new study, researchers found an alarming number of people in the U.S. are developing infections of either the heart’s inner lining or valves, known as infective endocarditis, in large part, due to the current opioid epidemic.

The research was conducted by a team from Cleveland Clinic Lerner College of Medicine.

Infective endocarditis occurs when bacteria or fungi in the blood stream enter the heart’s inner lining or valves.

Nearly 34,000 people receive treatment for this condition each year, of which approximately 20% die. One of the major risk factors for infective endocarditis is drug abuse.

According to the team, infective endocarditis related to drug abuse is a nationwide epidemic.

These patients are among the most vulnerable—young and poor, and also frequently have HIV, hepatitis C and alcohol abuse.

In the study, the team analyzed data in the National Inpatient Sample registry from 2002–2016 on nearly one million patients diagnosed with infective endocarditis.

They compared patients with heart infections related to drug abuse to those with heart infections from other causes.

During the 14 years studied, the researchers found that the prevalence ratio for drug-abuse-related heart infections nearly doubled in the United States, from 8% to 16%.

All geographic regions saw increases, and the highest jump occurred in the Midwest at nearly 5% per year.

They also found those with infective endocarditis related to drug abuse were predominantly young, white men (median age 38 years old);

Were poorer, with nearly 42% having a median household income in the lowest national quartile, and about 45% are covered by Medicaid;

Had higher rates of HIV, hepatitis C and alcohol abuse compared to patients with infective endocarditis who are not drug abusers;

Had longer hospital stays and higher health care costs; and were more likely to undergo heart surgery, yet less likely to die while hospitalized.

The team says nationwide public health measures need to be implemented to address this opioid epidemic, with targeted regional programs to specifically support patients at increased risk.

Appropriately, treating the heart 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.

The lead author of the study is Serge C. Harb, M.D., assistant professor of medicine at Cleveland Clinic Lerner College of Medicine.

The study is published in the Journal of the American Heart Association.

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