急性心包炎和心肌心包炎的发病率、临床表现、治疗和结局。
Incidence, clinical presentation, management, and outcome of acute pericarditis and myopericarditis.
机构信息
Department of Cardiology, Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland.
Deparment of Internal Medicine, University Hospital Basel, University of Basel, Petersgraben 4, CH-4031 Basel, Switzerland.
出版信息
Eur Heart J Acute Cardiovasc Care. 2022 Feb 8;11(2):137-147. doi: 10.1093/ehjacc/zuab108.
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.
目的
急性心包炎和心肌心包炎的流行病学、临床表现、治疗和预后情况鲜为人知。
方法和结果
瑞士 7 家急救中心以急性胸痛就诊的患者，其急性心包炎、心肌心包炎和非 ST 段抬高型心肌梗死（NSTEMI）的最终诊断由 2 位独立的心脏病专家根据所有信息（包括高敏心肌肌钙蛋白 T 的连续测量值）进行集中判定。心包炎和心肌心包炎的总体发病率与已确定的 NSTEMI 发病率相关。还评估了这两种疾病的当前治疗方法和长期预后。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）。因此，瑞士心包炎和心肌心包炎的估计发病率分别为每年每 10 万人 10.1（95%可信区间[95%CI]为 9.3-10.9）和 6.1（95%CI 为 5.6-6.7）例，而 NSTEMI 为每年每 10 万人 115.0（95%CI 为 112.3-117.6）例。心包炎（85%为男性，中位年龄 46 岁）和心肌心包炎（62%为男性，中位年龄 56 岁）均以男性为主，通常（50%和 97%）需要住院治疗。心包炎或心肌心包炎患者在 30 天内无死亡或危及生命的心律失常（发生率 0%（95%CI 为 0.0-4.8%））。与 NSTEMI 相比，心包炎和心肌心包炎的 2 年全因死亡率校正后的风险比为 0.40（95%CI 为 0.05-2.96），非心因性胸痛的风险比为 0.59（95%CI 为 0.40-0.88）。
结论
心包炎和心肌心包炎的发病率明显低于 NSTEMI，且短期和长期预后均良好。
临床试验注册
ClinicalTrials.gov，编号 NCT00470587，https://clinicaltrials.gov/ct2/show/NCT00470587。
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