Key result
Corticosteroid anti-inflammatory therapy in pediatric acute myocarditis did not reduce the risk of mortality compared to conventional therapy, but improved left ventricular ejection fraction by 11.93%.
Why the study?
The study was conducted to evaluate the efficacy of corticosteroids in the anti-inflammatory treatment of pediatric acute myocarditis.
Does corticosteroid anti-inflammatory therapy reduce mortality or improve left ventricular function in pediatric patients with acute myocarditis?
Meta-Analysis (n=604)
Does corticosteroid anti-inflammatory therapy reduce mortality or improve left ventricular function in pediatric patients with acute myocarditis?
Answers are grounded in this paper and cite their sources.
In pediatric acute myocarditis, corticosteroid therapy does not significantly reduce mortality but may improve left ventricular ejection fraction, though evidence is limited by small, heterogeneous studies.
BACKGROUND: To evaluate the efficacy of corticosteroids in anti-inflammatory treatment of pediatric acute myocarditis. METHODS: We searched PubMed, Embase and Cochrane library and included studies before October 2022 for clinical trials, observational studies and retrospective studies which reported on children with acute myocarditis treated with corticosteroid anti-inflammatory therapy. The quality of the clinical trials was assessed by Jadad score as an exclusion criterion. RESULTS: This systematic review included 6 studies involving 604 pediatric patients with acute myocarditis. Corticosteroid therapy was not associated with reduced risk of mortality due to acute myocarditis (P = 0.53; RR = 0.87; 95% CI = 0.58 to 1.33) compared to anti-failure treatment. There was a significant improvement in pediatric patients' left ventricular function measured by left ventricular ejection fraction in the group on corticosteroid anti-inflammatory treatment (P = 0.0009; MD = 11.93%; 95% CI = 4.87% to 18.99%). No conclusion can be drawn due to the high heterogeneity in meta-analyses of risk of getting to a clinical endpoint (death or heart transplantation) and changes in left ventricular end-diastolic diameter (LVEDD). CONCLUSIONS: Corticosteroid anti-inflammatory therapy in pediatric acute myocarditis patients showed no significant improvement in reducing the risk of mortality, but showed significant improvement in LVEF.
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Yao et al. (2023) conducted a meta-analysis in Pediatric acute myocarditis (n=604). Corticosteroids vs. Conventional anti-failure medication was evaluated on Mortality (RR 0.87, 95% CI 0.58-1.33, p=0.53). Corticosteroid anti-inflammatory therapy in pediatric acute myocarditis did not reduce the risk of mortality compared to conventional therapy, but improved left ventricular ejection fraction by 11.93%.
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