Highlights
- •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.
Abstract
Background
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.
Methods
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.
Results
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.
Conclusions
In acute pericarditis requiring hospitalization, in-hospital AE and recurrence were
each observed in >10 % of patients. Further large studies on treatment are warranted.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Published online: March 18, 2023
Accepted:
February 16,
2023
Received in revised form:
February 4,
2023
Received:
December 23,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.
