A rising Coxsackie virus antibody titre in patients with viral myocarditis was associated with a significantly higher 15-year mortality rate compared to a negative test (23.8% vs 0%; p<0.005).
Cohort (n=68)
No
Does confirmed Coxsackie virus infection predict higher long-term mortality in patients with viral myocarditis?
Patients with viral myocarditis and confirmed Coxsackie virus infection have a significantly higher 15-year mortality rate compared to those with negative serology, often progressing to chronic dilated cardiomyopathy.
Absolute Event Rate: 23.8% vs 0%
p-value: p=<0.005
From 1969 to 1973, 68 patients were admitted to the 4th Division of Medicine of the Brescia Civil Hospital with the diagnosis of viral myocarditis. The patients were divided into two groups according to the results of the Coxsackie virus complement fixing antibodies test: Group 1 (42 patients) with a fourfold or greater rising antibody titre; Group 2 (26 patients) with a negative serum test. Both groups were examined after a follow-up period of 15 years. Ten patients from Group 1 died. The diagnoses were chronic myocarditis (three cases); chronic cardiomyopathy-pulmonary embolism (one case); chronic cardiomyopathy-liver cirrhosis (one case); dilated cardiomyopathy-sudden death (two cases); congestive cardiomyopathy (three cases). No Group 2 patients died. The 15-year mortality rate of Group 1 was significantly higher than that of Group 2 (Fisher Test: p less than 0.005). In conclusion, the natural history of Coxsackie virus heart disease is characterized by two possibilities: a complete recovery from a clinical point of view, in some cases with only minor T wave abnormalities, or evolution into a chronic disease (dilated cardiomyopathy) having a high mortality rate within 10 years of the onset of the acute disease.
Levi et al. (1988) conducted a cohort in Viral myocarditis (n=68). Fourfold or greater rising Coxsackie virus antibody titre vs. Negative serum test for Coxsackie virus antibodies was evaluated on 15-year mortality (p=<0.005). A rising Coxsackie virus antibody titre in patients with viral myocarditis was associated with a significantly higher 15-year mortality rate compared to a negative test (23.8% vs 0%; p<0.005).