289 - One-Year Mortality among the Spectrum of Myopericardial Diseases

Abstract

Background: Myopericardial diseases involve a wide spectrum of conditions ranging from “pure” pericarditis to a “pure” myocarditis. It can also be “mixed” to varying degrees with both myocardial and pericardial involvement and presents as myopericarditis (MP) or perimyocarditis (PM). Outcomes between the different groups are poorly defined in the literature; we sought to identify the one-year mortality of them. Methods: This is a retrospective single-center study. With the use of the ICD-9 code and the Cleveland Clinic pericardial disease database, we identified 71 patients with a diagnosis of PM or MP between 2003 and 2015. MP was defined as patients with a diagnosis of acute pericarditis and elevation of cardiac markers without a new onset of depressed left ventricular (LV) function by echocardiography or CMR. PM was defined as patients with a diagnosis of acute pericarditis and elevation of cardiac markers and with a new onset of depressed LV function by echocardiography or CMR. Outcomes were compared to 84 consecutive patients with a diagnosis of myocarditis and 220 consecutive patients with a diagnosis of acute pericarditis between 2011 and 2012. Results: Among the PM/MP group (n = 71, of whom 38 MP and 33 PM; mean age of 35 years; 70% male), the one-year mortality was 6% (n = 4). In the myocarditis group (n = 84; mean age of 49; 60% male), the one-year mortality was 7% (n = 6). Within the acute pericarditis group (n = 220; mean age of 55; 64% male), one-year mortality was 2% (n = 4). Using Fisher's exact test, no significant difference was noted between the PM/MP group and the acute pericarditis group P = .1. However, there was a significant difference between the myocarditis and the acute pericarditis groups P = .03.In the multivariate analysis, we did not identify any variable that significantly correlated with the mortality. Conclusion: Mortality outcomes of acute pericarditis remain good regardless of the myocardial involvement. Myocarditis carries a higher risk of mortality compared to acute pericarditis, hence a closer follow-up for this group may be warranted.