The number of U.S. injection drug users hospitalized for infective endocarditis, or heart inflammation, increased substantially between the years 2000 and 2003, says a study reported in Clinical Infectious Diseases.
The jump may be attributable to rising methamphetamine use, says study lead author Hannah Cooper, ScD, assistant professor of behavioral science and health education, Rollins School of Public Health, Emory University.
Cooper used data from the Centers for Disease Control and Prevention National Hospital Discharge Survey collected between 1996 and 2003.
The research team identified cases of injection drug use (IDU)related infective endocarditis (IE) using two algorithms: one designed to be specific (only identifying cases that are definitely IDUrelated IE, at the risk of excluding some cases), and one designed to be sensitive (identifying more cases of IDUrelated IE, at the risk of including some false-positive results).
The algorithms indicated that the number of injection drug use related hospitalizations for infective endocarditis increased between 38 percent and 66 percent from 2000-2003. An exception was IDUrelated IE among people living with HIV or AIDS, which declined during the entire study period. The number of U.S. injection drug users remained constant.
"Rising methamphetamine use may be driving this increase," says Cooper. "Methamphetamine use induces a host of cardiac complications that can create vulnerability to endocarditis.
"Physicians and other health and social service organizations working with active drug users should be particularly vigilant in screening for endocarditis and in educating patients about related symptoms," says Cooper. "Early treatment of endocarditis significantly reduces mortality for this infection."
In addition to Cooper, study authors were J.E. Brady, S. Friedman, K. Gostnell, and B. Tempalski, all of the National Development and Research Institute (NDRI); and D. Ciccarone of the University of California at San Francisco.
The study was funded by the National Institute on Drug Abuse, a branch of the National Institutes of Health.
Reference: Clin Infect Dis. 2007;45(9):1200–1203