National Trends, Gender, Management, and Outcomes of Patients Hospitalized for Myocarditis

Incidence and outcomes of hospital treated acute myocarditis from 2003 to 2015 in Spain

“…We found an increase of hospital discharges with the diagnosis of myocarditis from 15 to 30 per million inhabitants from 2003 to 2015. Although a similar trend has been found in two analyses of the National Inpatient Sample Database in the United States of America, performed from 1998 to 2013 16 and 2007 to 2014, 17 these are the first data on myocarditis hospitalizations trends in an European country. Possible explanation for this increase could a better detection of AM nowadays with the widespread availability of troponin assays and magnetic resonance imaging, higher awareness of physicians for this diagnosis or a true rise in the incidence of the disease, although our study cannot provide a certain answer for this question.…”

“…The European Society of Cardiology position statement on AM management 1 acknowledges that, although a large variety of infectious agents, drugs, systemic diseases and toxins can cause this condition, the aetiology of AM often remains undetermined, and our findings confirm that assertion. Indeed, no data on myocarditis aetiology are provided by most studies based in the analysis of large administrative data 14‐18 or multicentre registries, 11 and the only study of this kind that reported that information found an 85% of uncharacterised aetiology 13 …”

“…One of the possible explanations for this wide range of mortality is the different settings and populations selected in different studies, with lowest rates (0%) in some single‐centre cohort studies recently published 9,10 ; intermediate ones (2.3%‐6%) in a multicentre contemporary registry, 11 large administrative databases, 16,17 and other single‐centre cohort studies 8 ; higher rates (14.5%‐17%) in patients admitted to the intensive care unit 5,14 ; and the highest ones (39%‐45%) in those requiring extracorporeal membrane oxygenator 7,14 or with a fulminant course 5 . Our figures are consistent with those observed in studies based in the analysis of large administrative databases in other Western countries, 16,17 and can be considered as a confirmation of the moderate mortality rate for most patients admitted to hospital with this condition.…”

Autoimmunity in Acute Myocarditis: How Immunopathogenesis Steers New Directions for Diagnosis and Treatment

“…Another study included data from the USA on 27,129 hospitalizations with discharge diagnosis myocarditis from 2007 to 2014. Cardiogenic shock and ventricular fibrillation/cardiac arrest occurred in 6.5% and 2.5%, respectively, with females being more affected than males [14]. The global incidence of myocarditis in 2017 as reported by the Global Burden of Disease project was 3,071,000 cases [15].…”

Myocardial fibrosis: why image, how to image and clinical implications

“…Myocarditis is an inflammatory disease of the myocardium which can be acute, subacute or chronic and is caused by a variety of aetiologies—most commonly viral or idiopathic. The true incidence is difficult to ascertain but there appears to be a trend of increasing hospitalisation in recent years, in part due to high-sensitivity cardiac troponin assays and access to CMR 39. Myocarditis may be present in up to 12% of young adults presenting with sudden death and can lead to other diseases such as DCM 40.…”