Intravenous immunoglobulin therapy significantly reduced in-hospital mortality (OR 0.44) and improved left ventricular ejection fraction in patients with acute myocarditis.
Meta-Analysis (n=1,534)
Does intravenous immunoglobulin (IVIG) therapy reduce in-hospital mortality and improve left ventricular function in children and adults with acute myocarditis?
In a meta-analysis of 1,534 patients, IVIG therapy was associated with significantly lower in-hospital mortality and improved left ventricular ejection fraction in children and adults with acute myocarditis.
Odds Ratio: 0.44 (95% CI 0.17–0.71)
valor p: p=< 0.001
The efficacy of intravenous immunoglobulin (IVIG) in the treatment of acute myocarditis remains controversial. The aim of this study was to conduct a meta-analysis to assess the efficacy of IVIG in children and adults with acute myocarditis.We searched PubMed, Scopus, Embase, Medline, the Cochrane Library, Google Scholar, and the ClinicalTrials.gov website. Eligible studies were clinical trials of patients with acute myocarditis who received IVIG therapy. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were used to estimate the outcomes.Thirteen studies with 1534 cases were incorporated into our meta-analysis. Pooled results showed that IVIG therapy significantly reduced in-hospital mortality (OR: 0.44, 95% CI 0.17 to 0.71, P < 0.001) and improved the left ventricular ejection fraction (LVEF) (OR: 1.73, 95% CI 1.34 to 2.13, P < 0.001) in acute myocarditis patients. Furthermore, patients with acute fulminant myocarditis (AFM) exhibited a significantly higher survival rate (OR: 2.80, 95% CI 1.16 to 6.77, P = 0.022) in the IVIG group.IVIG therapy can not only result in lower in-hospital mortality and superior recovery of left ventricular function in patients with acute myocarditis, but also increase the survival rate of AFM patients. The present study provides some supportive evidence for IVIG therapy in acute myocarditis patients.
Huang et al. (Thu,) conducted a meta-analysis in Acute myocarditis and acute fulminant myocarditis (n=1,534). Intravenous Immunoglobulin (IVIG) vs. No IVIG therapy was evaluated on In-hospital mortality (OR 0.44, 95% CI 0.17 to 0.71, p=< 0.001). Intravenous immunoglobulin therapy significantly reduced in-hospital mortality (OR 0.44) and improved left ventricular ejection fraction in patients with acute myocarditis.