Key result
Systematic aetiological assessment in acute myocarditis yields only 1 new autoimmune diagnosis despite frequent autoantibodies.
Why the study?
Myocarditis is commonly diagnosed in the intensive care cardiology unit, but no current recommendations or guidelines exist to aid in its aetiological assessment.
Does systematic aetiological assessment improve prediction of clinical or therapeutic outcomes in patients with acute myocarditis?
Cohort (n=84)
Does systematic aetiological assessment improve prediction of clinical or therapeutic outcomes in patients with acute myocarditis?
Routine comprehensive aetiological blood panels in acute myocarditis patients in the ICCU have limited clinical utility for guiding therapy or predicting outcomes.
Answers are grounded in this paper and cite their sources.
Systematic aetiological panels may identify myocarditis causes in the ICCU; leaves open whether they improve outcomes or warrant guideline adoption.
Background: Myocarditis is commonly diagnosed in the intensive care cardiology unit (ICCU). No current recommendation nor guideline aids aetiological assessment. Methods: From September 2021 to October 2023, 84 patients with acute myocarditis underwent thorough and systematic serum and blood cell panel evaluations to determine the most common causes of the myocarditis. Results: Of the 84 patients (median age 34 years, range 22–41 years, 79% male), 16 presented with complicated myocarditis. The systematic aetiological assessment revealed that 36% of patients were positive for lupus anticoagulant, 12% for antinuclear antibodies, 8% for anti-heart antibodies, and 12% for anti-striated muscle antibodies. Viral serology did not yield any significant results. After the aetiological assessment, one patient was diagnosed with an autoimmune inflammatory disorder (Still’s disease). T-cell subset analyses indicated that myocarditis severity tended to increase with the T-cell lymphopenia status. Conclusions: A comprehensive, systematic aetiological assessment was of limited value in terms of predicting the clinical or therapeutic outcomes in myocarditis patients presenting to the ICCU.
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Michel et al. (2024) conducted a cohort in acute myocarditis (n=84). Systematic aetiological assessment was evaluated on Most common causes of myocarditis. A systematic aetiological assessment in 84 acute myocarditis patients revealed lupus anticoagulant in 36% and antinuclear antibodies in 12%, but yielded only 1 new autoimmune diagnosis.
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