IE is becoming more frequent.[17]Talha KM, Baddour LM, Thornhill MH, et al. Escalating incidence of infective endocarditis in Europe in the 21st century. Open Heart. 2021 Oct;8(2):e001846.
https://openheart.bmj.com/content/8/2/e001846
http://www.ncbi.nlm.nih.gov/pubmed/34670832?tool=bestpractice.com
In the US, one study found that between 2000 and 2011, the incidence of IE increased from 11 per 100,000 to 15 per 100,000.[18]Pant S, Patel NJ, Deshmukh A, et al. Trends in infective endocarditis incidence, microbiology, and valve replacement in the United States from 2000 to 2011. J Am Coll Cardiol. 2015 May 19;65(19):2070-6.
https://www.doi.org/10.1016/j.jacc.2015.03.518
http://www.ncbi.nlm.nih.gov/pubmed/25975469?tool=bestpractice.com
Between 2000 and 2020 in Europe, IE incidence increased 4.1% per year.[17]Talha KM, Baddour LM, Thornhill MH, et al. Escalating incidence of infective endocarditis in Europe in the 21st century. Open Heart. 2021 Oct;8(2):e001846.
https://openheart.bmj.com/content/8/2/e001846
http://www.ncbi.nlm.nih.gov/pubmed/34670832?tool=bestpractice.com
Another study looking at the incidence of drug use-related IE between 2002 to 2016 found the overall incidence of IE increased from 18 per 10,000 to 29 per 10,000, and the incidence in those with drug use-related IE increased from 48 per 10,000 to 79 per 10,000.[19]Kadri AN, Wilner B, Hernandez AV, et al. Geographic trends, patient characteristics, and outcomes of infective endocarditis associated with drug abuse in the United States from 2002 to 2016. J Am Heart Assoc. 2019 Oct;8(19):e012969.
https://www.doi.org/10.1161/JAHA.119.012969
http://www.ncbi.nlm.nih.gov/pubmed/31530066?tool=bestpractice.com
In hospital mortality from IE is 15% to 30%.[20]Otto CM, Nishimura RA, Bonow RO, et al. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Joint Committee on clinical practice guidelines. Circulation. 2021 Feb 2;143(5):e72-227.
https://www.ahajournals.org/doi/full/10.1161/CIR.0000000000000923
[21]Rajani R, Klein JL. Infective endocarditis: a contemporary update. Clin Med (Lond). 2020 Jan;20(1):31-5.
https://www.sciencedirect.com/science/article/pii/S1470211824036492?via%3Dihub
http://www.ncbi.nlm.nih.gov/pubmed/31941729?tool=bestpractice.com
In resource-rich countries, IE is more common in the setting of previous valve surgery or as a consequence of iatrogenic or nosocomial infection, whereas chronic rheumatic disease is an uncommon antecedent. Rheumatic heart disease remains the leading cause of IE in developing countries.[22]Noubiap JJ, Nkeck JR, Kwondom BS, et al. Epidemiology of infective endocarditis in Africa: a systematic review and meta-analysis. Lancet Glob Health. 2022 Jan;10(1):e77-86.
https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(21)00400-9/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/34919859?tool=bestpractice.com
[23]Hubers SA, DeSimone DC, Gersh BJ, et al. Infective endocarditis: a contemporary review. Mayo Clin Proc. 2020 May;95(5):982-97.
https://www.mayoclinicproceedings.org/article/S0025-6196(19)31081-X/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/32299668?tool=bestpractice.com
IE in pregnancy is rare and is associated with intravenous drug abuse and pre-existing cardiac disease and, in particular, mechanical prosthetic valves, where the incidence is higher than in the general population.[24]Onofrei VA, Adam CA, Marcu DTM, et al. Infective endocarditis during pregnancy-keep it safe and simple!. Medicina (Kaunas). 2023 May 12;59(5):939.
https://www.mdpi.com/1648-9144/59/5/939
http://www.ncbi.nlm.nih.gov/pubmed/37241171?tool=bestpractice.com
Maternal mortality reaches 18% to 22% and is usually due to embolic events or heart failure.[7]Delgado V, Ajmone Marsan N, de Waha S, et al. 2023 ESC guidelines for the management of endocarditis. Eur Heart J. 2023 Oct 14;44(39):3948-4042.
https://academic.oup.com/eurheartj/article/44/39/3948/7243107
http://www.ncbi.nlm.nih.gov/pubmed/37622656?tool=bestpractice.com
[24]Onofrei VA, Adam CA, Marcu DTM, et al. Infective endocarditis during pregnancy-keep it safe and simple!. Medicina (Kaunas). 2023 May 12;59(5):939.
https://www.mdpi.com/1648-9144/59/5/939
http://www.ncbi.nlm.nih.gov/pubmed/37241171?tool=bestpractice.com