Abstract
Results: The nine fatal cases of myocarditis occurred 1996–2006 and were diagnosed at autopsy. Before death, three had no symptoms of illness and only three had cardiac-specific diagnostic results. None was investigated by cardiac imaging techniques, and for none was myocarditis suspected pre-death. Duration of clozapine was 14–33 days for the fatal cases. Comparison with 66 non-fatal cases indicated no significant difference in gender, age, smoking status, dose at onset or concomitant sodium valproate. However, obesity (BMI> 30 kg/m2) was significantly more frequent among fatal than non-fatal cases (67% vs 26%; p 1000U/l was also associated with death (p= 0.0004). Conclusions:Routinemonitoring formyocarditis for the first four weeks of clozapine with or without symptoms of illness, anddiscontinuation of clozapine in the presence of evidence consistentwithmyocarditismay assist to prevent fatalities. Obesity may increase the risk of mortality and CK>1000U/l may indicate life-threatening illness. doi:10.1016/j.hlc.2010.06.764
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