Increasing amount of heart infections linked to opioid crisis

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An increasingly high number of people in America are developing heart infections due to the current opioid epidemic, new research suggests.

The problem of heart infections is predominately affecting young, white, poor men who also have higher rates of HIV, hepatitis C and alcohol abuse, according to new research published in the Journal of the American Heart Association.

The infections, known as 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 in America, of which approximately 20% die.

One of the major risk factors for infective endocarditis is drug abuse – particularly opioids.

Opioid link

The study’s senior author Serge C. Harb, assistant professor of medicine at Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, said: “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.”

During the 14 years studied, 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 hospitalised. Lower death rates are likely due to their significantly younger age.

Dr Harb said: “Nationwide public health measures need to be implemented to address this epidemic, with targeted regional programs to specifically support patients at increased risk of heart infections.

“Specialised teams, including but not limited to cardiologists, infectious disease specialists, cardiac surgeons, nurses, addiction specialists, case managers and social workers, are needed to care for these patients.

“Appropriately treating the cardiovascular infection is only one part of the management plan. Helping these patients address their addictive behaviours with social supports and effective rehabilitation programs is central to improving their health and preventing drug abuse relapses.”

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