Abstract

Aims

Little is known about the epidemiology, clinical presentation, management, and outcome of acute pericarditis and myopericarditis.

Methods and results

The final diagnoses of acute pericarditis, myopericarditis, and non-ST-segment elevation myocardial infarction (NSTEMI) of patients presenting to seven emergency departments in Switzerland with acute chest pain were centrally adjudicated by two independent cardiologists using all information including serial measurements of high-sensitivity cardiac troponin T. The overall incidence of pericarditis and myopericarditis was estimated relative to the established incidence of NSTEMI. Current management and long-term outcome of both conditions were also assessed. Among 2533 chest pain patients, the incidence of pericarditis, myopericarditis, and NSTEMI were 1.9% (n = 48), 1.1% (n = 29), and 21.6% (n = 548), respectively. Accordingly, the estimated incidence of pericarditis and myopericarditis in Switzerland was 10.1 [95% confidence interval (95% CI) 9.3–10.9] and 6.1 (95% CI 5.6–6.7) cases per 100 000 population per year, respectively, vs. 115.0 (95% CI 112.3–117.6) cases per 100 000 population per year for NSTEMI. Pericarditis (85% male, median age 46 years) and myopericarditis (62% male, median age 56 years) had male predominance, and commonly (50% and 97%, respectively) resulted in hospitalization. No patient with pericarditis or myopericarditis died or had life-threatening arrhythmias within 30 days [incidence 0% (95% CI 0.0–4.8%)]. Compared with NSTEMI, the 2-year all-cause mortality adjusted hazard ratio of pericarditis and myopericarditis was 0.40 (95% CI 0.05–2.96), being 0.59 (95% CI 0.40–0.88) for non-cardiac causes of chest pain.

Conclusion

Pericarditis and myopericarditis are substantially less common than NSTEMI and have an excellent short- and long-term outcome.

Clinical trial registration

ClinicalTrial.gov, number NCT00470587, https://clinicaltrials.gov/ct2/show/NCT00470587.

中文翻译：

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急性心包炎和心肌心包炎的发病率、临床表现、治疗和结局

摘要

目标

对急性心包炎和心肌心包炎的流行病学、临床表现、治疗和结果知之甚少。

方法和结果

在瑞士七个急诊科就诊的急性胸痛患者的急性心包炎、心肌心包炎和非 ST 段抬高型心肌梗死 (NSTEMI) 的最终诊断由两名独立的心脏病专家使用所有信息进行集中裁决，包括对高敏感性心肌肌钙蛋白 T。相对于已确定的 NSTEMI 发病率，估计了心包炎和心肌心包炎的总发病率。还评估了这两种情况的当前管理和长期结果。在 2533 例胸痛患者中，心包炎、心肌心包炎和 NSTEMI 的发生率分别为 1.9%（n  = 48）、1.1%（n  = 29）和 21.6%（n = 548），分别。因此，瑞士的心包炎和心肌心包炎的估计发病率分别为 10.1 [95% 置信区间 (95% CI) 9.3–10.9] 和 6.1 (95% CI 5.6–6.7) 例/100 000 人每年，而 115.0 (95% CI 112.3–117.6) NSTEMI 每年每 10 万人中的病例数。心包炎（85% 男性，中位年龄 46 岁）和心肌心包炎（62% 男性，中位年龄 56 岁）以男性为主，通常（分别为 50% 和 97%）导致住院。没有心包炎或心肌心包炎患者在 30 天内死亡或出现危及生命的心律失常 [发生率 0% (95% CI 0.0–4.8%)]。与 NSTEMI 相比，心包炎和心肌心包炎的 2 年全因死亡率调整后的风险比为 0.40（95% CI 0.05-2.96），非心源性胸痛的风险比为 0.59（95% CI 0.40-0.88）。

结论

与 NSTEMI 相比，心包炎和心肌心包炎的发病率大大降低，并且具有极好的短期和长期结果。

临床试验注册

ClinicalTrial.gov，编号 NCT00470587，https://clinicaltrials.gov/ct2/show/NCT00470587。