Infective endocarditis: a growing threat despite medical progress. A look at trends in Spain

Infective endocarditis (IE) is a serious public health problem both in Spain and worldwide. This study aimed to analyze the trends in the incidence of IE in Spain from 1992 to 2021.

We used IE incidence data from the Global Health Data Exchange and population data from the Spanish National Statistics Institute to analyze changes in age-standardized incidence rates. Joinpoint and Age-Period-Cohort (A-P-C) models were applied to identify significant trend changes and the effects of age, period, and birth cohort.

The age-standardized incidence rates of IE increased from 17.5 cases per 100 000 population in 1992 to 30.8 per 100,000 in 2021 among men and from 16.8 per 100 000 in 1992 to 22.9 per 100 000 in 2021 among women. Joinpoint analysis revealed distinct trend changes, with men having a faster rate of increase (1.9%) compared with women (1.1%). The male-to-female incidence rate ratio peaked at 1.4, indicating a higher risk of IE among men. The incidence of IE was significantly influenced by age, period, and cohort. Both sexes showed increasing risk with age. Risk increased in women born in the late 20th and early 21st centuries compared with earlier cohorts. Men in these later cohorts showed a decreasing risk. Period effects increased from the 1990s to the mid-2000s and then declined, especially among men.

This study reveals a significant increase in the incidence of IE in Spain, especially among older adults and men. These trends reflect demographic changes, medical advances, and changing risk factors.