Deaths from bacterial infections in the heart are on the rise among young people who inject drugs

Infective endocarditis (IE)—a bacterial infection in the heart or blood vessels— affects 40,000–50,000 patients in the United States per year and has a 1-year average mortality rate of 30%. People who inject drugs (PWID) tend to be younger and have a higher risk for IE due to the entrance of bacteria in the bloodstream. In fact, IE cases among younger patients and PWID have increased, likely as a result of the ongoing opioid epidemic. A recent analysis published in the Journal of Internal Medicine reveals that the risk of death from IE among young US residents aged 15–44 years old has doubled in the last 2 decades. Additionally, the percentage of PWID among young people who die of IE has reached almost 20%.

By examining US Center for Disease Control and Prevention data based on death certificates, investigators found the following (with age-adjusted rates per 100,000 persons):

• IE mortality rates for the entire US population decreased from 2.1 in 1999 to 1.8 in 2020; however, during that time, mortality rates among young US residents doubled, increasing from 0.3 in 1999 to 0.6 in 2020.
• Among people aged 15–34 years old, mortality rates tripled from 0.1 to 0.3.
• Young people comprised 10.0% of all IE deaths in 2020, an increase from 6.8% in 1999.
• The percent of PWID among all patients that died of IE increased from 1.1% in 1999 to 3.0% in 2020; the same percent among the young increased from 10.2% in 1999 to 19.5% in 2020.
• White Americans comprised almost 90% of all young US PWID that died of IE in 2020 compared with 77% in 1999.

"The number of young people in the US who die of infective endocarditis is increasing, and the ongoing opioid epidemic, specifically injectable drug abuse, appears to be a significant cause," said corresponding author Polydoros Kampaktsis, MD, Ph.D., of the Columbia University Irving Medical Center.