• Posted December 13, 2023

Drug Abuse Is Fueling Surge in Heart Infections Among Young Americans

While rates of a deadly heart infection are dropping generally across the United States, a new report finds one exception: Young adults.

In that group, rates of infective endocarditis are rising, probably fueled by a common cause, injected drug abuse.

"Substance use was listed as a contributing cause that could explain the higher death rates in the younger age groups and also in the states in those who died due to endocarditis,” said study lead author Dr. Sudarshan Balla, an associate professor of medicine at the West Virginia University Heart and Vascular Institute in Morgantown, W.V.

His team published its findings Dec. 13 in the Journal of the American Heart Association.

According to the AHA, infective endocarditis occurs when bacteria infiltrate the heart's lining, a heart valve or nearby blood vessel. Infective endocarditis is typically rare, a disease seen mainly in folks with congenital heart issues or replacement heart valves.

However, abuse of injected drugs can also raise a person's odds for infective endocarditis.

The new study used data from the U.S. Centers for Disease Control and Prevention to track infective endocarditis death rates for 1999 through 2020.

Over that time period, deaths from the condition declined across the U.S. population generally. Overall, such deaths fell from 26 per million persons in 1999 to 22 per million persons in 2020.

Folks aged 55 and older saw the greatest decline in deaths linked to infective endocarditis.

But such deaths rose sharply among people ages 25 to 44, Balla's group added. For example, the rate rose by 2% annually among Americans aged 25 to 34, and by 5% annually among those ages 35 to 44, they said.

It's not just infective endocarditis that poses a health threat to people battling substance abuse. Among those aged 25 to 44, substance abuse was linked to between a two-fold and seven-fold rise for many common causes of death, the researchers noted.

“We speculate that this acceleration was likely, in the most part, due to the opioid crisis that has engulfed several states and involved principally younger adults," Balla said in an AHA news release.

Indeed, West Virginia was one of the states hit hardest by the surge in drug-linked infective endocarditis. According to the study, rates of death from the condition rose highest in Kentucky, Tennessee and West Virginia.

The researchers called the surge in deaths "alarming."

To help save lives, Balla believes “comprehensive care plans for those treated for infective endocarditis should also include screening and treatment for substance use disorder.”

It's the use of dirty needles by those who misuse drugs that can introduce bacteria into the bloodstream. Once there, it can end up in the heart.

Besides raising the risk for infective endocarditis, misuse of injected drugs also heightens risks for other infectious diseases, such as HIV, viral hepatitis, and bacterial and fungal infections.

Some states are introducing "harm reduction" programs (such as clean needle exchanges) to tackle the problem, the researchers said.

“Whether these programs make an impact is yet to be determined,” Balla said.

More information

There's more on endocarditis at the Cleveland Clinic.

SOURCE: American Heart Association, news release, Dec. 13, 2023