Aikawa Hirohiko, Fujino Masashi, Nakao Kazuhiro, Nakai Michikazu, Kanaoka Koshiro, Sumita Yoko, Miyamoto Yoshihiro, Takagi Kensuke, Otsuka Fumiyuki, Kataoka Yu, Asaumi Yasuhide, Tahara Yoshio, Nicholls Stephen J, Tsujita Kenichi, Noguchi Teruo
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan.
Department of Advanced Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
JACC Asia. 2024 Aug 27;4(10):721-731. doi: 10.1016/j.jacasi.2024.06.008. eCollection 2024 Oct.
Acute autoimmune pericarditis (AAP) is an uncommon disease with diverse etiology. Data regarding AAP diagnosis and outcomes are scant.
This study sought to describe the diagnosis and the rates of in-hospital mortality, cardiac tamponade, and readmission of AAP.
This study used a nationwide Japanese claim-based database to identify patients with AAP from April 2016 to March 2020 compared with patients with acute idiopathic pericarditis (AIP).
Of 20,469 hospitalized patients with acute pericarditis, 170 had AAP and 5,027 had AIP of new onset. The diagnosis for AAP was systemic lupus erythematosus in 23.5% (40 of 170), rheumatoid arthritis in 19.4% (33 of 170), systemic sclerosis in 8.2% (14 of 170), other in 17.7% (30 of 170), and undifferentiated in 31.2% (53 of 170). During hospitalization, 1.8% (3 of 170) of patients with AAP and 1.5% (73 of 5,027) of patients with AIP died, and cardiac tamponade occurred in 8.8% (15 of 170) of AAP patients and 4.7% (237 of 5,027) of AIP patients. The incidence of cardiac tamponade was highest in patients with systemic lupus erythematosus (15.0%; 6 of 40). AAP was more associated with cardiac tamponade than AIP (adjusted OR: 1.82; 95% CI: 1.02-3.23). There was no difference between the AAP and AIP groups with regard to rehospitalization, although this was more common in patients with undifferentiated forms of autoimmune disease ( = 0.001).
This Japanese national registry study of acute pericarditis revealed no differences in rehospitalization for recurrence between patients with AAP and AIP. It also underscored the diversity in AAP diagnosis, with more than 30% of patients lacking a differentiated diagnosis.
急性自身免疫性心包炎（AAP）是一种病因多样的罕见疾病。关于AAP诊断和预后的数据很少。
本研究旨在描述AAP的诊断情况以及住院死亡率、心脏压塞和再入院率。
本研究使用了日本全国基于索赔的数据库，以识别2016年4月至2020年3月期间的AAP患者，并与急性特发性心包炎（AIP）患者进行比较。
在20469例住院的急性心包炎患者中，170例患有AAP，5027例为新发AIP。AAP的诊断中，系统性红斑狼疮占23.5%（170例中的40例），类风湿关节炎占19.4%（170例中的33例），系统性硬化症占8.2%（170例中的14例），其他占17.7%（170例中的30例），未分化型占31.2%（170例中的53例）。住院期间，AAP患者中有1.8%（170例中的3例）死亡，AIP患者中有1.5%（5027例中的73例）死亡；心脏压塞在AAP患者中发生率为8.8%（170例中的15例），在AIP患者中为4.7%（5027例中的237例）。系统性红斑狼疮患者心脏压塞的发生率最高（15.0%；40例中的6例）。与AIP相比，AAP与心脏压塞的相关性更强（校正比值比：1.82；95%置信区间：1.02 - 3.23）。AAP组和AIP组在再入院方面没有差异，尽管在未分化型自身免疫性疾病患者中更常见（P = 0.001）。
这项日本全国性急性心包炎登记研究显示，AAP患者和AIP患者复发再入院情况没有差异。它还强调了AAP诊断的多样性，超过30%的患者缺乏明确诊断。
