Infectious Endocarditis-Related Stroke Increase Related to Opioid Epidemic

In research presented at the International Stroke Conference in Honolulu, HI and published in the journal Stroke, a correlation between increasing rates of infectious endocarditis-related stroke and increasing opiod use. Through analysis of data from an inpatient hospital database, records for 5,283 patients hospitalized with stroke, infectious endocarditis, and opioid abuse between 1993 and 2015 were identified. 

The number of patients with all 3 diagnoses increased by a factor of 7.8 from 2.4 to 18.8 per 10 million people from 1993 to 2015. In comparison, the rate of hospitalization for all stroke increased by only a factor of 3.5, which all occurred between 2008 and 2015, coincident with the increase in opioid use in the US. The increase in stroke hospitalizations was most dramatic in nonHispanic white patients in the northeastern and southern US. Higher increases were also seen among women and those younger than age 45. 

Setareh Salehi Omran, MD, lead author of the study and a fellow in vascular neurology at the Weill Cornell Medical Center and Columbia University Medical Center in New York said, “The rise in hospitalizations for infective endocarditis-related stroke associated with opioids parallels the rise in heroin overdose-related complications and deaths, which tripled between 2010 and 2015. I believe efforts to minimize prescription opioid abuse are important in addressing this public health problem, since the highly addictive nature of opioids can lead some people to turn to cheaper alternatives, such as injectable opioids like heroin.”