The effects of gender and age on occurrence of clinically suspected myocarditis in adulthood

Kytö, Ville; Sipilä, Jussi; Rautava, Päivä

doi:10.1136/heartjnl-2013-304449

Cited by 114 publications

(102 citation statements)

References 29 publications

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“…For example, we show that advanced HF from myocarditis occurs mostly in young male patients. These age and sex differences are consistent with previous reports, where myocarditis has been shown to affect younger patients [12][13][14] and to be linked to male sex hormones. 6,15 The diagnosis of myocarditis was associated with higher acuity at listing, evidenced by a 10-fold higher requirement for biventricular MCS, 5-fold higher requirement for ECMO, and 3-fold higher requirement for ventilator need.…”

Section: Discussionsupporting

confidence: 82%

Characteristics and Outcomes of Patients With Myocarditis Listed for Heart Transplantation

ElAmm

Al‐Kindi

Oliveira

2016

Circ: Heart Failure

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Background-Myocarditis can cause dilated cardiomyopathy resulting in end-stage heart failure requiring advanced therapies. There is little contemporary information on the clinical progression, need for mechanical circulatory support, and outcomes of orthotopic heart transplantation of these patients. Despite higher allosensitization, patients with myocarditis had similar post-transplant rejection, retransplantation, and survival rates compared with other groups. Conclusions-Patients with the diagnosis of myocarditis listed for orthotopic heart transplantation are younger, sicker, and recover more frequently but require more biventricular mechanical circulatory support. Heart transplantation survival is comparable to that of patients with other types of heart failure. (Circ Heart Fail. 2016;9:e003259. Methods and Results-We

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Section: Discussionsupporting

confidence: 82%

Characteristics and Outcomes of Patients With Myocarditis Listed for Heart Transplantation

ElAmm

Al‐Kindi

Oliveira

2016

Circ: Heart Failure

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“…discovered that myocarditis was more common in men (76.61%; 95% CI 75.11–78.05%) than in women (23.39%; 95% CI : 21.95–24.89%, P < 0.0001) and that men are significantly more susceptible to myocarditis than women. [20] In addition, the authors of another study found that women with myocarditis were more likely to develop ventricular arrhythmias than men with myocarditis ( OR = 2.43, 95% CI : 1.12–5.27) and that women possessed longer QT intervals, as demonstrated by electrocardiography, due to decreases in the expression levels of some pivotal proteins. [21] Moreover, myocarditis prolongs ventricular repolarization times in approximately 70% of patients.…”

Section: Discussionmentioning

confidence: 99%

A Risk Prediction Model for In-hospital Mortality in Patients with Suspected Myocarditis

Zhao

Gao

et al. 2017

Chinese Medical Journal

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Background:Myocarditis is an inflammatory disease of the myocardium that may lead to cardiac death in some patients. However, little is known about the predictors of in-hospital mortality in patients with suspected myocarditis. Thus, the aim of this study was to identify the independent risk factors for in-hospital mortality in patients with suspected myocarditis by establishing a risk prediction model.Methods:A retrospective study was performed to analyze the clinical medical records of 403 consecutive patients with suspected myocarditis who were admitted to Ningbo First Hospital between January 2003 and December 2013. A total of 238 males (59%) and 165 females (41%) were enrolled in this study. We divided the above patients into two subgroups (survival and nonsurvival), according to their clinical in-hospital outcomes. To maximize the effectiveness of the prediction model, we first identified the potential risk factors for in-hospital mortality among patients with suspected myocarditis, based on data pertaining to previously established risk factors and basic patient characteristics. We subsequently established a regression model for predicting in-hospital mortality using univariate and multivariate logistic regression analyses. Finally, we identified the independent risk factors for in-hospital mortality using our risk prediction model.Results:The following prediction model for in-hospital mortality in patients with suspected myocarditis, including creatinine clearance rate (Ccr), age, ventricular tachycardia (VT), New York Heart Association (NYHA) classification, gender and cardiac troponin T (cTnT), was established in the study: P = ea/(1 + ea) (where e is the exponential function, P is the probability of in-hospital death, and a = −7.34 + 2.99 × [Ccr <60 ml/min = 1, Ccr ≥60 ml/min = 0] + 2.01 × [age ≥50 years = 1, age <50 years = 0] + 1.93 × [VT = 1, no VT = 0] + 1.39 × [NYHA ≥3 = 1, NYHA <3 = 0] + 1.25 × [male = 1, female = 0] + 1.13 × [cTnT ≥50 μg/L = 1, cTnT <50 μg/L = 0]). The area under the receiver operating characteristic curve was 0.96 (standard error = 0.015, 95% confidence interval [CI]: 0.93-0.99). The model demonstrated that a Ccr <60 ml/min (odds ratio [OR] = 19.94, 95% CI: 5.66–70.26), an age ≥50 years (OR = 7.43, 95% CI: 2.18–25.34), VT (OR = 6.89, 95% CI: 1.86–25.44), a NYHA classification ≥3 (OR = 4.03, 95% CI: 1.13–14.32), male gender (OR = 3.48, 95% CI: 0.99–12.20), and a cTnT level ≥50 μg/L (OR = 3.10, 95% CI: 0.91–10.62) were the independent risk factors for in-hospital mortality.Conclusions:A Ccr <60 ml/min, an age ≥50 years, VT, an NYHA classification ≥3, male gender, and a cTnT level ≥50 μg/L were the independent risk factors resulting from the prediction model for in-hospital mortality in patients with suspected myocarditis. In addition, sufficient life support during the early stage of the disease might improve the prognoses of patients with suspected myocarditis with multiple risk factors for in-hospital mortality.

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“…Lack of readily available sensitive and specific clinical diagnostic tests, wide variation in diagnostic criteria, and selected patient populations among published studies have hampered accurate estimations of epidemiology and natural history of myocarditis. According to experimental and clinical studies, however, young male adolescents and adults are considered most susceptible to viral myocarditis . In children, all ages from newborns to adolescents are affected, but 2 incidence peaks have been shown to occur: in infants aged <1 year and in teenagers …”

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confidence: 99%

Occurrence and Features of Childhood Myocarditis: A Nationwide Study in Finland

Arola

Pikkarainen

Sipilä

et al. 2017

JAHA

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BackgroundEpidemiology of myocarditis in childhood is largely unknown. Men are known to have a higher incidence of myocarditis than women in adults aged <50 years, but whether this is true by sex in pediatric age groups is unknown. We set out to study the occurrence and potential sex differences of myocarditis in a general pediatric population.Methods and ResultsData of all hospital admissions with myocarditis in Finland occurring in patients aged ≤15 years from 2004 to 2014 were collected from a mandatory nationwide registry. All patients with myocarditis as a primary, secondary, or tertiary cause of admission were included. Total and age‐ and sexspecific incidence rates were calculated using corresponding population data. There were 213 admissions with myocarditis in pediatric patients. Myocarditis was the primary cause of admission in 86%. The overall incidence rate of myocarditis was 1.95/100 000 person‐years. Of all patients, 77% were boys, but sex differences in incidence rates were age‐dependent. In children aged 0 to 5 years, there was no sex difference in the occurrence of myocarditis. Boys aged 6 to 10 years had a higher incidence rate compared with girls (72% boys; incidence rate ratio: 2.46; 95% confidence interval, 1.03–5.89; P=0.04). Sex difference further increased in children aged 11 to 15 years (80% boys; incidence rate ratio: 3.5; 95% confidence interval, 2.68–5.67; P<0.0001).ConclusionsMyocarditis leading to hospital admission is relatively uncommon in children, but occurrence of myocarditis increases with age. There is no sex difference in the risk of myocarditis during the first 6 years of life, but boys have a significantly higher risk at ages 6 to 15 years.

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The effects of gender and age on occurrence of clinically suspected myocarditis in adulthood

Cited by 114 publications

References 29 publications

Characteristics and Outcomes of Patients With Myocarditis Listed for Heart Transplantation

Characteristics and Outcomes of Patients With Myocarditis Listed for Heart Transplantation

A Risk Prediction Model for In-hospital Mortality in Patients with Suspected Myocarditis

Occurrence and Features of Childhood Myocarditis: A Nationwide Study in Finland

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