ArticleOpen heart2025
Characteristics and prognosis in acute myocarditis and unexplained acute chest pain: a nationwide longitudinal cohort study.
Article in Open heart, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors.
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Abstract
aimsAcute myocarditis (AM) is a disease with variable prognosis, ranging from complete recovery to end-stage heart failure (HF) and death but often challenging to differentiate from unexplained acute chest pain (UCP) in the acute setting. This study examines the short-tem and long-term outcomes of AM compared with UCP, focusing on the risk of HF development.
methodsWe used the Swedish Web System for Enhancement of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies-registry to identify patients >16 years admitted to hospital between 1 January 1998 and 31 December 2018 with either AM or UCP. Patients were followed for outcomes including mortality, rehospitalisation and HF development over both short-term (30 days) and long-term periods. Cox proportional hazards models were used to compare the risks, adjusting for demographic and clinical-related factors.
resultsA total of 3792 patients with AM and 109 934 patients with UCP were included. Median follow-up time was 7.8 years (Q1, Q3; 3.4, 12.3). AM patients were younger compared with UCP patients, median age 37 years (Q1, Q3; 26, 52) vs 59 years (Q1, Q3; 49, 69) and more likely to be men (79.9% vs 51.4%, p<0.001). Comorbidity burden was less pronounced within the AM cohort. Chest pain was the most common presenting symptom in both groups. Mortality rate at 30 days (OR 3.75, 95% CI 1.9 to 7.3, p<0001) as well as long term (OR 2.0, 95% CI 1.69 to 2.39, p<0.001) were significantly higher in AM patients compared with UCP. AM patients were more likely to develop HF during follow-up (OR 2.3, 95% CI 1.81 to 2.93, p<0001).
conclusionsAM is associated with worse short-term and long-term outcomes compared with UCP, including a higher risk of developing HF even after the first year.
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