Cleveland Clinic Study Finds Drug Abuse-Related Heart Infections Rising at Alarming Rate in the United States

Drug abuse-related infective endocarditis most common in Midwest  

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Cleveland Clinic researchers have found that drug abuse-related heart infections are increasing at an alarming rate in the United States. The researchers found that all regions across the country have seen an increase of infective endocarditis, with the largest increases in the Midwest.

Researchers reviewed nearly one million hospitalizations across the country from 2002-2016 using the National Inpatient Sample Registry for patients admitted with infective endocarditis, a serious and potentially fatal condition that occurs when bacteria enters the blood stream and sticks to the lining of heart valves.

The study found patients with drug abuse-related infective endocarditis were more likely to be younger (with a median age of 38 years old), male, Caucasian, on Medicaid, and low-income, while also being more likely to have HIV, hepatitis C and alcohol abuse problems – compared to those with non-drug abuse-related infective endocarditis.

“Between 2002 and 2016 nationwide hospitalizations for infection of the heart valves related to drug abuse have nearly doubled from 8% to 16%,” said Serge Harb, M.D., a Cleveland Clinic cardiologist and senior author of the study. “Treating the infection is only part of the management plan. The bigger picture is to help these patients and provide them with social support, put them in effective rehab programs, and help them with their addictive behaviors so that we can prevent relapses.”

The paper was published today in the Journal of the American Heart Association.

According to the CDC, drug overdoses nearly tripled from 1999 to 2014. In infective endocarditis, bacteria in the blood stream causes growths and produce toxins and enzymes that destroy the tissue the valves. Endocarditis can cause a leaky heart valve, heart failure, abscesses around the heart valve, and stroke. If left untreated endocarditis could be fatal.

The study further showed people with drug abuse-related heart valve infections had longer hospital stays and incurred higher medical costs.

Additional study findings include:

  • The median age of patients with drug abuse infective endocarditis varied by region, from 37 years old in the south to 41 years old in the west.
  • The majority of patients were white males across all regions.
  • Patients with drug abuse-related infective endocarditis were more likely to have a median household income in the 0-25th percentile and predominantly had Medicaid insurance.
  • Patients with drug abuse-related infective endocarditis had fewer comorbidities such as hypertension, diabetes, congestive heart failure, renal and lung disease than the non-drug abuse-related group.
  • The Midwest had the highest rate of cardiac surgery for drug abuse-related infective endocarditis.


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