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 in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association.
Researchers examined death certificate data from the Centers for Disease Control and Prevention’s (CDC) Multiple Cause of Death dataset, which contains death rates and population counts for all U.S. counties. They looked for national trends in deaths caused by infective endocarditis, plus differences in deaths related to age, sex, race and geography among states from 1999-2020. Researchers also analyzed the association with substance use disorder, considering the emergence of the opioid epidemic during the study’s time frame.
The analysis found:
- In the 21-year period analyzed, infective endocarditis death rates declined overall in the U.S.
- Death rates increased significantly for young adults, at an average annual change of more than 5% for the 25-34 age group and more than 2% for the 35-44 age group.
- In the 45-54 age category, death rates remained stagnant at 0.5%, and there was a significant decline among those aged 55 and older.
- Substance use disorder associated with multiple causes of death increased drastically – between 2-fold and 7-fold among the 25-44 age group.
- Kentucky, Tennessee and West Virginia showed an acceleration in deaths caused by infective endocarditis in contrast to other states with either a predominant decline or no change.
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.
Researchers were limited in the medical details they could collect because of the use of death certificate data, which may contain inaccuracies, such as errors in diagnosis, data entry and cause of death. For similar reasons, researchers could not determine a direct cause-and-effect relationship between the rise in deaths caused by infective endocarditis in younger adults and substance use disorder.
