Abstract
Introduction: Patients with myocarditis have variable prognosis. Large population-based studies are required for further clarification. In this case cohort study, the aim was to determine the mortality rate among people affected by myocarditis compared to age- and sex-matched population controls.
Methods: Nationwide healthcare registries were used to identify patients who were hospitalized and diagnosed with myocarditis between 1999-2015 in Denmark. Myocarditis patients were matched 1:5 to population controls, using birth year, sex and calendar month of the myocarditis event. Two-year all-cause mortality was reported using Kaplan-Meier estimates and shared Frailty Cox regression, with hazard ratios (HRs) and 95% confidence intervals (CI). Due to a steep mortality rate in the first month of follow-up, where the proportional hazards assumption was violated, we used a Split function to report HRs for after one month to two-year follow-up.
Results: Of 15,532 subjects enrolled, 2,589 were diagnosed with myocarditis and 12,945 were controls. The median age was 48 in both groups. Relative to controls, myocarditis patients had higher cardiac and non-cardiac comorbidity. The crude 2-year mortality was 13.7% (95% CI 12.42-15.08) in the myocarditis group (Figure 1), compared to 3.31% (95% CI 3.00-3.61) among controls, with a crude HR of 3.23 (95% CI 2.77-3.78). The corresponding HR, adjusted for age, sex and comorbidities was 2.83 (95% CI 2.39-3.36). When excluding preexisting comorbidities, 2-year all-cause mortality was 5.6% for myocarditis patients (95% CI 4.5-6.8) vs. 1.7% for controls (95% CI 1.5-1.9).
Conclusions: Patients with myocarditis have significantly higher mortality relative to age- and sex- matched population controls. Our results suggest myocarditis patients should be actively investigated and treated with plans for follow-up. Our findings suggest that the prognosis among patients with myocarditis have a poor prognosis, even when adjusted for comorbidities. The most deaths occur during the first month.
Methods: Nationwide healthcare registries were used to identify patients who were hospitalized and diagnosed with myocarditis between 1999-2015 in Denmark. Myocarditis patients were matched 1:5 to population controls, using birth year, sex and calendar month of the myocarditis event. Two-year all-cause mortality was reported using Kaplan-Meier estimates and shared Frailty Cox regression, with hazard ratios (HRs) and 95% confidence intervals (CI). Due to a steep mortality rate in the first month of follow-up, where the proportional hazards assumption was violated, we used a Split function to report HRs for after one month to two-year follow-up.
Results: Of 15,532 subjects enrolled, 2,589 were diagnosed with myocarditis and 12,945 were controls. The median age was 48 in both groups. Relative to controls, myocarditis patients had higher cardiac and non-cardiac comorbidity. The crude 2-year mortality was 13.7% (95% CI 12.42-15.08) in the myocarditis group (Figure 1), compared to 3.31% (95% CI 3.00-3.61) among controls, with a crude HR of 3.23 (95% CI 2.77-3.78). The corresponding HR, adjusted for age, sex and comorbidities was 2.83 (95% CI 2.39-3.36). When excluding preexisting comorbidities, 2-year all-cause mortality was 5.6% for myocarditis patients (95% CI 4.5-6.8) vs. 1.7% for controls (95% CI 1.5-1.9).
Conclusions: Patients with myocarditis have significantly higher mortality relative to age- and sex- matched population controls. Our results suggest myocarditis patients should be actively investigated and treated with plans for follow-up. Our findings suggest that the prognosis among patients with myocarditis have a poor prognosis, even when adjusted for comorbidities. The most deaths occur during the first month.
| Bidragets oversatte titel | Øget mortalitet efter hospitalisering med myocarditis - et nationelt register-baseret follow-up studie |
|---|---|
| Originalsprog | Engelsk |
| Artikelnummer | Abstract 16197 |
| Tidsskrift | Circulation |
| Vol/bind | 138 |
| Udgave nummer | Suppl. 1 |
| Antal sider | 1 |
| ISSN | 0009-7322 |
| Status | Udgivet - 5 nov. 2018 |
| Begivenhed | Scientific Sessions of the American Heart Association, AHA - Chicago, Illinois, USA Varighed: 10 nov. 2018 → 12 nov. 2018 |
Konference
| Konference | Scientific Sessions of the American Heart Association, AHA |
|---|---|
| Land/Område | USA |
| By | Chicago, Illinois |
| Periode | 10/11/2018 → 12/11/2018 |
Emneord
- myocarditis
- registry
FN’s Verdensmål
Denne publikation bidrager til følgende verdensmål
