Epidemiology

IE is becoming more frequent.[17]​ 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] Between 2000 and 2020 in Europe, IE incidence increased 4.1% per year.[17]​ 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]​ In hospital mortality from IE is 15% to 30%.[20][21]

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][23]

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]​ Maternal mortality reaches 18% to 22% and is usually due to embolic events or heart failure.[7]​​​[24]

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