Spike in infective endocarditis-related stroke coincides with opioid abuse rise
A sharp increase in U.S. hospitalization rates for stroke from opioid-related infective endocarditis since 2008 has coincided with the rise of the opioid epidemic, according to data presented at the International Stroke Conference.
“Our findings add to the urgency of addressing the underlying opioid epidemic in the United States and suggest that people need to be more aware that stroke can be a devastating complication of injecting opioids,” S. Salehi Omran, MD, a fellow in vascular neurology at the Weill Cornell Medical Center and Columbia University Medical Center, said in a press release. “The incidence of opioid-related infective endocarditis has been increasing over the past 20 years, particularly among younger patients.”
Omran and colleagues analyzed data from the National Inpatient Sample between 1993 and 2015 to identify hospitalized patients who had the combination of opioid abuse, infective endocarditis and stroke. National Inpatient Sample survey rates were used to calculate nationally representative estimates and population estimates from the U.S. Census Bureau to calculate age- and sex-adjusted annual hospitalization rates per 10 million person-years.
The researchers identified 5,283 patients hospitalized with stroke from endocarditis secondary to opioid abuse during the study period and found an increase of those incidents from 2.4 (95% CI, 0.5-4.3) to 18.8 (95% CI, 14.4-23.3) hospitalizations per 10 million U.S. residents.
Omran and colleagues detected no significant change in incidence from 1993 to 2008 (annual percentage change, 2%; 95% CI, –2 to 6), but observed an increase from 2008 to 2015 (annual percentage change, 20%; 95% CI, 11-31).
The most drastic annual increase of stroke hospitalizations were in non-Hispanic white patients in the northeastern and southern U.S., the researchers reported, and the greatest increases in the past decade occurred in women and in adults younger than 45 years.
“The rise in hospitalizations for infective endocarditis-related stroke associated with opioid parallels the rise in heroin overdose-related complications and deaths, which tripled between 2010 and 2015,” Omran said in the release. “I believe efforts to minimize prescription opioid abuse are important in addressing this public health problem, since the highly addictive nature of opioids can lead some people to turn to cheaper alternatives, such as injectable opioids like heroin.” – by Earl Holland Jr.
Omran SS, et al. Abstract 8, Session A2: Community/Risk Factors Oral Abstracts I. Presented at: International Stroke Conference; Feb. 6-8, 2019; Honolulu.
Disclosure: Omran reports no relevant financial disclosures.