Key result
Acute myocarditis linked to ~16-fold higher 90-day all-cause mortality versus matched controls.
Why the study?
Incidence and severity of acute myocarditis vary widely, and epidemiological data on short-term risks of mortality, heart failure, and ventricular arrhythmias are lacking.
Does acute myocarditis increase the short-term risk of mortality, heart failure, and ventricular arrhythmias compared to the general population?
Cohort (n=15,138)
Yes
Does acute myocarditis increase the short-term risk of mortality, heart failure, and ventricular arrhythmias compared to the general population?
Absolute Event Rate: 4.9% vs 0.3%
p-value: p=<0.001
Acute myocarditis is associated with a significantly elevated short-term risk of mortality, heart failure, and ventricular arrhythmias, highlighting the need for careful early monitoring.
Acute myocarditis signals high short-term mortality risk; leaves open whether targeted interventions improve outcomes.
OBJECTIVE: Incidence and severity of acute myocarditis vary significantly in previous reports and there is a lack of epidemiological studies on the short-term risks of mortality, heart failure and ventricular arrhythmias in patients with acute myocarditis. Therefore, study aims were to examine 90-day risks of mortality, heart failure (HF) and ventricular arrhythmias in patients with acute myocarditis in comparison to age-matched and sex-matched background population controls. METHODS: In this nationwide register-based follow-up study of patients hospitalised with myocarditis between 2002 and 2018 in Denmark, 90-day risks of all-cause mortality, HF, ventricular arrhythmias (ventricular tachycardia, ventricular fibrillation (VF)), cardiac arrest and implantable cardioverter-defibrillator (ICD) implantation were compared with age-matched and sex-matched controls from the background population (1:5 matching). Absolute risks standardised to the age, sex and comorbidity distribution of the entire study population were derived from multivariable Cox regression. RESULTS: A total of 2523 patients hospitalised with myocarditis were included. Median age was 48 years (Q1-Q3: 30-69) and 67.7% were men. Comorbidity burden was more pronounced among patients with myocarditis relative to controls. Standardised 90-day all-cause mortality risk was 4.9% for patients with acute myocarditis versus 0.3% for controls (p<0.001). Ninety-day standardised risks for other endpoints were 7.5% versus 0.1% for HF, 1.9% versus <0.1% for VF/VF/arrest risk and 1.6% versus <0.1% for ICD implantation (all p<0.001). CONCLUSIONS: In this large nationwide register-based follow-up study, patients hospitalised with myocarditis had significantly higher 90-day risks of all-cause mortality, HF, ventricular arrhythmias, cardiac arrest and ICD implantation compared with background population controls.
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Kragholm et al. (2021) conducted a cohort in Acute myocarditis (n=15,138). Acute myocarditis vs. Age- and sex-matched background population controls was evaluated on 90-day all-cause mortality (p=<0.001). Acute myocarditis was associated with a significantly higher 90-day standardized risk of all-cause mortality (4.9% vs 0.3%, p<0.001) compared with matched population controls.
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