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Increased 1-year mortality among patients discharged following hospitalization for pericarditis - a nationwide cohort study

Session Blockbusters from the Young in myocardial and pericardial disease

Speaker Flora Lind Sigvardt

Event : ESC Congress 2019

  • Topic : valvular, myocardial, pericardial, pulmonary, congenital heart disease
  • Sub-topic : Pericardial Disease – Epidemiology, Prognosis, Outcome
  • Session type : Abstract Sessions

Authors : FL Sigvardt (Copenhagen,DK), ML Hansen (Copenhagen,DK), SL Kristensen (Copenhagen,DK), F Gustafsson (Copenhagen,DK), M Ghanizada (Copenhagen,DK), GH Gislason (Copenhagen,DK), C Madelair (Copenhagen,DK)

Authors:
F.L. Sigvardt1 , M.L. Hansen1 , S.L. Kristensen1 , F. Gustafsson2 , M. Ghanizada2 , G.H. Gislason1 , C. Madelair1 , 1Gentofte University Hospital - Copenhagen - Denmark , 2Rigshospitalet - Copenhagen University Hospital - Copenhagen - Denmark ,

Citation:
European Heart Journal ( 2019 ) 40 ( Supplement ), 3094

Background: Pericarditis accounts for 5% of all chest pain referrals to the emergency department and is generally considered a benign condition. However, recent studies suggested that pericarditis can be an early predictor of malignant disease, but data on mortality and other morbidity after incident pericarditis is lacking.

Purpose: To assess mortality risk and hospitalization patterns in patients with incident pericarditis.

Methods: In nationwide Danish registries we identified patients discharged from hospital with a first-time diagnosis of pericarditis from 1996 to 2016. Patients with prior myocarditis, heart failure, myocardial infarction and recent thoracic surgery were excluded.

The patients were risk set matched with 8 controls each from the general population on sex and year of birth. We assessed 1-year mortality risk using Kaplan Meier and logistic regression adjusted for baseline comorbidities; cerebrovascular disease, chronic obstructive lung disease, cardiac dysrhythmias, ischaemic heart disease and malignancy. We identified subsequent hospital admissions due to new onset cardiovascular-, respiratory- or malignant disease. Differences in frequencies between the pericarditis group and controls were calculated with Chi squared test.

Results: We identified 8,077 patients with pericarditis, median age 45 years (IQR: 32–59) and 75.6% were men. The absolute 1-year mortality was 2.9% in patients with pericarditis compared to 0.8% in the control group (p<0.001) (Figure 1).

The adjusted odds ratio (OR) of 1-year mortality was 2.79 (95%-CI: 2.14–3.65, p<0.001). Within the first year after incident pericarditis, hospital admission due to recurrent pericarditis was observed in 10.6% of the patients. Further, we observed significantly higher frequencies of other hospital admissions compared to the matched controls; cardiovascular disease: 4.6% vs, 1.2%, p>0.001, respiratory disease: 3.4% vs. 0.7%, p>0.001) and malignant disease: 1.4% vs. 0.5%, p>0.001).

Conclusion: In a nationwide cohort of patients discharged from hospital with incident pericarditis, we observed more than a triple 1-year mortality compared to age- and sex matched controls. Further, we observed a higher frequency of both cardiovascular and non-cardiovascular hospital admissions, highlighting the need for more focus on underlying morbidity in patients presenting with pericarditis.

Figure 1

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