Global burden of myocarditis in adolescents and young adults, 1990–2019

BACKGROUND AND OBJECTIVE: Early myocarditis has increased the risk of heart failure, arrhythmias, and sudden cardiac death. We aimed to estimate the global burden of myocarditis in adolescents and young adults from 1990 to 2019. METHODS: We analysed incident cases and the age-standardized rates of incidence, death, and disability-adjusted life years (DALYS) of myocarditis in 204 countries and territories from 1990 to 2019 in young people (aged 15-39) from the Global Burden of Disease Study stratified by age and sex. Predictions up to 2030 were obtained via Norpred analysis. RESULTS: In 2019, the global number of myocarditis incident cases in adolescents and young adults increased to 1,265,800, with a 62.2% increase from 1990. The global incidence rate declined from 16.74 per 100,000 population in 1990 to 16.00 in 2019. From 1990 to 2019, the high sociodemographic index regions presented the highest estimated annual percentage change in incidence (-0.41, 95% CI= -0.49 to -0.34). In 2019, the ASDR was 15.81 (95% CI = 14.92 to 16.56), with the middle sociodemographic index quintile being the highest contributor (73,671.19 DALYs). The incidence, mortality, and DALYs of myocarditis will be stable or decrease from 2020 to 3030. Males had higher levels of the above indicators than females. CONCLUSION: While the total number of cases has grown globally in the past three-decades, the incidence rate of myocarditis has declined, with the burden disproportionately affecting males and middle-SDI populations, which highlights the need for targeted prevention.