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Risk of constrictive pericarditis after acute pericarditis
Massimo Imazio1, Antonio Brucato, Silvia Maestroni
1Cardiology Department, Maria Vittoria Hospital, Torino, Italy. massimo_imazio@yahoo.it
Circulation
|August 17, 2011
Summary
Constrictive pericarditis (CP) is rare after viral or idiopathic pericarditis but more frequent with other causes. This study quantifies CP risk across various acute pericarditis etiologies.
Area of Science:
- Cardiology
- Infectious Diseases
- Oncology
Background:
- Constrictive pericarditis (CP) is a rare but serious complication of acute pericarditis.
- Prospective data on CP risk stratified by etiology are limited.
- Understanding these risks is crucial for patient management and prognosis.
Purpose of the Study:
- To prospectively evaluate the incidence and risk of developing constrictive pericarditis (CP) after a first episode of acute pericarditis.
- To analyze CP development based on the underlying etiology of acute pericarditis.
- To provide long-term follow-up data on CP evolution.
Main Methods:
- Prospective cohort study of 500 consecutive patients with a first episode of acute pericarditis.
- Long-term follow-up (median 72 months) to monitor for development of CP.
- Etiological classification included viral/idiopathic, connective tissue disease, neoplastic, tuberculosis, and purulent pericarditis.
Main Results:
- Constrictive pericarditis (CP) developed in 1.8% of patients (9/500) over the follow-up period.
- CP risk was low (<0.5%) for viral/idiopathic pericarditis but significantly higher for nonviral/nonidiopathic causes (8.3%).
- Incidence rates per 1000 person-years varied widely, from 0.76 for idiopathic/viral to 52.74 for purulent pericarditis.
Conclusions:
- Constrictive pericarditis (CP) is a rare complication of viral or idiopathic acute pericarditis.
- Specific etiologies, particularly bacterial (purulent) and tuberculous pericarditis, confer a substantially higher risk of developing CP.
- Risk stratification by etiology is essential for predicting CP development after acute pericarditis.
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