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ASA: Endocarditis, Related Strokes Up During Opioid Epidemic

WEDNESDAY, March 17, 2021 -- The incidence of infective endocarditis and resultant neurovascular complications has increased during the opioid epidemic, according to a study presented at the American Stroke Association International Stroke Conference, held virtually from March 17 to 19.

Nguyen Hoang, M.D., from The Ohio State University in Columbus, and colleagues retrospectively analyzed data from 351 patients treated for infective endocarditis during 54 months (Jan. 1, 2014, through July 1, 2018) to assess the relationship between concomitant intravenous drug use (IVDU) and infective endocarditis.

The researchers found that 170 patients (48 percent) had a history of IVDU-associated endocarditis. During the study period, there was a 630 percent increased incidence of patients with IVDU-associated endocarditis. A significant number of patients with IVDU-associated endocarditis were homeless (5.9 versus 1.1 percent), uninsured (10.0 versus 2.8 percent), and unemployed (75.9 versus 31.7 percent) compared with patients with endocarditis of other etiologies. The investigators also observed an association between IVDU and an increased prevalence of overall intracranial hemorrhage, including intraparenchymal hemorrhage, subarachnoid hemorrhage, and cerebral microbleeds, as well as an increased prevalence of infectious intracranial aneurysm and brain abscesses.

"Patients who are known IV drug users who have endocarditis should be more carefully screened for symptoms of cardiovascular disease," a coauthor said in a statement.

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