Deaths from heart valve infections dropped but rose in young adults in U.S

Death rates related to infective endocarditis declined in most adults across the U.S. within the last two decades, yet accelerated among young adults ages 25 to 44 years old, according to new research published today in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association.

Infective endocarditis, also called bacterial endocarditis, is an infection caused by bacteria that enter the bloodstream and settle in the heart lining, a heart valve or a blood vessel. The disease is rare, however, people with previous valve surgeries, heart valve abnormalities, artificial valves, congenital heart defects or previous infective endocarditis have a greater risk of developing it. It can also be a complication of injecting illicit drugs.

An analysis of death certificate data from 1999 to 2020 showed a decline in deaths related to infective endocarditis throughout most of the United States yet found an alarming increase of 2%-5% among adults ages 25-44.

There was a notable increase in the diagnosis of substance use disorder among the young adults with infective endocarditis listed as the underlying cause of death.

Three states at the epicenter of the opioid crisis— Kentucky, Tennessee and West Virginia — had significant increases in death rates related to infective endocarditis.

“We found that 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,” Balla said.

The study researchers call the rise of infective endocarditis as the underlying cause of death in adults 25-44 years old “alarming” and recommend more investigation to identify the reasons for these trends among young adults and in the three states noted. Researchers speculate the increase is connected to the opioid crisis that has engulfed several states and involves primarily younger adults.

Reference: Deaths from heart valve infections drop across U.S. overall, but surged among young adults; Journal of the American Heart Association; DOI:10.1161/JAHA.123.031589