Characterization and long-term outcomes of patients with myocarditis: a retrospective observational study
Shelly Meron Grossman1, Nili Schamroth Pravda2, Katia Orvin2
1Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Insights
Long-term follow-up of myocarditis patients shows a good prognosis, with low mortality. Older age and poor heart function increase mortality risk, while higher albumin levels improve it.
Area of Science:
- Cardiology
- Internal Medicine
- Clinical Research
Background:
- Limited long-term follow-up data exists for myocarditis patients.
- Myocarditis requires further investigation regarding long-term outcomes.
Purpose of the Study:
- To investigate the long-term clinical outcomes of patients diagnosed with myocarditis.
- To identify risk factors associated with mortality and adverse outcomes in myocarditis patients.
- To compare the clinical course and outcomes of fulminant versus non-fulminant myocarditis.
Main Methods:
- Retrospective observational analysis of 203 myocarditis patients over a 10-year period (May 2004 - Dec 2014).
- Primary outcome was all-cause mortality; risk factors and clinical outcomes were analyzed.
- Comparison of characteristics and outcomes between fulminant and non-fulminant myocarditis groups.
Main Results:
- Overall mortality was 4.4% during a median follow-up of 56.9 months.
- Independent predictors of mortality included older age and poorer New York Heart Association (NYHA) function class.
- Higher albumin levels at presentation were associated with decreased mortality.
- Fulminant myocarditis patients experienced a more severe disease course and higher in-hospital mortality (13.3% vs. 0%).
Conclusions:
- Myocarditis patients generally have a good long-term prognosis, with favorable survival rates.
- Recovery without residual left ventricular dysfunction is common.
- Identifying risk factors like age, NYHA class, and albumin levels aids in predicting outcomes.
Introduction:
There is limited data on the long-term follow-up of patients with myocarditis.
Aim:
To investigate the long-term follow-up of patients with myocarditis.
Material And Methods:
We performed a retrospective observational analysis on the clinical long-term outcomes of patients with myocarditis over a 10-year period. The primary outcome was mortality. We identified risk factors for mortality and adverse clinical outcomes. We also compared the characteristics and outcomes of patients presenting with fulminant myocarditis to those presenting with non-fulminant myocarditis.
Results:
Between May 2004 and December 2014, 203 patients with myocarditis or perimyocarditis were admitted to our center. Most patients were male (87.7%) with a median age at presentation of 33 years (interquartile range: 25.4-38.9). The median follow-up period was 56.9 months (interquartile range 25.3-87.3 months), during which the overall mortality was 4.4% (9 patients). Fifteen patients presented with fulminant myocarditis. After multivariable analysis, older age (HR = 1.11, 95% CI: 1.05-1.16, p < 0.001) and a poorer New York Heart Association (NYHA) function class (HR = 4.6, 95% CI: 1.18-18, p = 0.028) were found to be independently associated with a higher risk of mortality, whereas higher albumin levels at presentation (HR = 0.2, 95% CI: 0.07-0.56, p = 0.002) were associated with decreased mortality. The group presenting with fulminant myocarditis had a more severe course of disease and a higher in-hospital mortality (13.3% vs. 0%, p = 0.005).
Conclusions:
The overall prognosis of patients with myocarditis is good - in terms of both survival and recovery without residual left ventricular dysfunction.
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