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Contemporary Trends and Outcomes of Infective Endocarditis Associated With Substance Use Disorders: A Nationwide
Rupal Aroza1, Islam Y Elgendy2, Kory Heier3
1Department of Pharmacy Practice and Science, College of Pharmacy University of Kentucky Lexington KY USA.
Journal of the American Heart Association
|August 7, 2026
Summary
Infective endocarditis (IE) hospitalizations declined in patients with substance use disorders (SUDs) but rose in others. Despite lower mortality in the SUD group, IE remains a significant concern, particularly for young adults and women.
Area of Science:
- Cardiology
- Infectious Diseases
- Public Health
Background:
- Infective endocarditis (IE) is a severe condition often associated with substance use disorders (SUDs).
- Contemporary data on IE hospitalizations, especially post-opioid surge during COVID-19, are limited.
Purpose of the Study:
- To analyze trends in IE hospitalizations among patients with and without SUDs.
- To identify factors associated with in-hospital mortality in IE patients.
Main Methods:
- Utilized the Vizient Clinical Data Base for hospitalizations with IE diagnoses (2016-2023).
- Compared IE hospitalization trends in SUD versus non-SUD groups.
- Applied multivariable logistic regression to determine mortality predictors.
Main Results:
- Of 120,142 IE hospitalizations, 21.9% involved patients with SUD.
- IE hospitalizations decreased in the SUD group (19.6% to 16.2%) but increased in the non-SUD group (80.4% to 83.8%).
- In-hospital mortality was lower for patients with SUD (9.8%) versus non-SUD (14.1%). Older age, fungemia, and hemodialysis predicted mortality.
Conclusions:
- IE associated with SUD continues to impact the US population, disproportionately affecting young adults and women.
- Further investigation is needed to understand the underlying reasons for these observed trends.
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