- •There are no studies on acute pericarditis in Japan.
- •12.3 % of patients with acute pericarditis suffered in-hospital adverse events.
- •Cardiac tamponade occurred in 10.8 % of patients with acute pericarditis.
- •Rehospitalization for pericarditis occurred in 10.5 % of patients during 2.5 years.
- •Further large studies on therapies of acute pericarditis are warranted.
Acute pericarditis occasionally requires invasive treatment, and may recur after discharge. However, there are no studies on acute pericarditis in Japan, and its clinical characteristics and prognosis are unknown.
This was a single-center, retrospective cohort study of clinical characteristics, invasive procedures, mortality, and recurrence in patients with acute pericarditis hospitalized from 2010 to 2022. The primary in-hospital outcome was adverse events (AEs), a composite of all-cause mortality and cardiac tamponade. The primary outcome in the long-term analysis was hospitalization for recurrent pericarditis.
The median age of all 65 patients was 65.0 years [interquartile range (IQR), 48.0–76.0 years], and 49 (75.3 %) were male. The etiology of acute pericarditis was idiopathic in 55 patients (84.6 %), collagenous in 5 (7.6 %), bacterial in 1 (1.5 %), malignant in 3 (4.6 %), and related to previous open-heart surgery in 1 (1.5 %). Of the 8 patients (12.3 %) with in-hospital AE, 1 (1.5 %) died during hospitalization and 7 (10.8 %) developed cardiac tamponade. Patients with AE were less likely to have chest pain (p = 0.011) but were more likely to have symptoms lasting 72 h after treatment (p = 0.006), heart failure (p < 0.001), and higher levels of C-reactive protein (p = 0.040) and B-type natriuretic peptide (p = 0.032). All patients complicated with cardiac tamponade were treated with pericardial drainage or pericardiotomy. We analyzed 57 patients for recurrent pericarditis after excluding 8 patients: 1 with in-hospital death, 3 with malignant pericarditis, 1 with bacterial pericarditis, and 3 lost to follow-up. During a median follow-up of 2.5 years (IQR 1.3–3.0 years), 6 patients (10.5 %) had recurrences requiring hospitalization. The recurrence rate of pericarditis was not associated with colchicine treatment or aspirin dose or titration.
In acute pericarditis requiring hospitalization, in-hospital AE and recurrence were each observed in >10 % of patients. Further large studies on treatment are warranted.
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- Management of acute and recurrent pericarditis: JACC state-of-the-art review.J Am Coll Cardiol. 2020; 75: 76-92
- Cardiac tamponade in still disease: a review of the literature.South Med J. 2009; 102: 832-837
- Purulent pericarditis: report of 2 cases and review of the literature.Medicine. 2009; 88 (Baltimore): 52-65
- Malignant pericardial effusion.Cardiology. 2013; 124: 224-232
- Evaluation and treatment of pericarditis: a systematic review.JAMA. 2015; 314: 1498-1506
- 2015 ESC guidelines for the diagnosis and management of pericardial diseases: the Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC)Endorsed by: the European Association for Cardio-Thoracic Surgery (EACTS).Eur Heart J. 2015; 36: 2921-2964
- Clinical practice.Acute pericarditis.N Engl J Med. 2004; 351: 2195-2202
- A randomized trial of colchicine for acute pericarditis.N Engl J Med. 2013; 369: 1522-1528
- Corticosteroids for recurrent pericarditis: high versus low doses: a nonrandomized observation.Circulation. 2008; 118: 667-671
- Risk factors for morbidity and mortality following hospitalization for pericarditis.J Am Coll Cardiol. 2020; 76: 2623-2631
- Risk of constrictive pericarditis after acute pericarditis.Circulation. 2011; 124: 1270-1275
- Prevalence of C-reactive protein elevation and time course of normalization in acute pericarditis: implications for the diagnosis, therapy, and prognosis of pericarditis.Circulation. 2011; 123: 1092-1097
- Management, risk factors, and outcomes in recurrent pericarditis.Am J Cardiol. 2005; 96: 736-739
- Usefulness of neutrophil-to-lymphocyte ratio for predicting acute pericarditis outcomes.Acta Cardiol. 2022; : 422-430
- Prednisolone and Mycobacterium indicus pranii in tuberculous pericarditis.N Engl J Med. 2014; 371: 1121-1130
- Complicated pericarditis: understanding risk factors and pathophysiology to inform imaging and treatment.J Am Coll Cardiol. 2016; 68: 2311-2328
- Colchicine for recurrent pericarditis (CORP): a randomized trial.Ann Intern Med. 2011; 155: 409-414
- Aspirin hepatitis.Am J Dis Child. 1975; 129: 1433-1434
- Effect of aspirin administration on serum glutamic oxaloacetic and glutamic pyruvic transaminases in children.Proc Soc Exp Biol Med. 1956; 93: 84-88
- Hepatic damage due to aspirin.Naika. 1966; 17: 749-755
- Effect of cyclooxygenase-2 inhibition on renal function in elderly persons receiving a low-salt diet. A randomized, controlled trial.Ann Intern Med. 2000; 133: 1-9
- Acetaminophen, aspirin, and chronic renal failure.N Engl J Med. 2001; 345: 1801-1808
- Phase 3 trial of interleukin-1 trap rilonacept in recurrent pericarditis.N Engl J Med. 2021; 384: 31-41
- Behçet's disease and familial Mediterranean fever: two sides of the same coin or just an association? A cross-sectional study.Eur J Intern Med. 2017; 39: 75-78
Published online: March 18, 2023
Accepted: February 16, 2023
Received in revised form: February 4, 2023
Received: December 23, 2022
Publication stageIn Press Corrected Proof
© 2023 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.