Mortality in primary and secondary myocarditis

Lymphocytic myocarditis presents as a primary disorder or in association with a systemic disease. Whether primary and secondary myocarditis have the same prognosis is unknown. Patients (n = 171) referred to the Johns Hopkins Cardiomyopathy service from 1984 to 1998 with newly diagnosed cardiomyopath...

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Bibliographic Details
Published in:The American heart journal 2004-04, Vol.147 (4), p.746-750
Main Authors: Pulerwitz, Todd C, Cappola, Thomas P, Felker, G.Michael, Hare, Joshua M, Baughman, Kenneth L, Kasper, Edward K
Format: Article
Language:English
Subjects:
Adult
Age
Biological and medical sciences
Cardiology. Vascular system
Female
Follow-Up Studies
Heart
HIV Infections - complications
Hospitals
Humans
Intubation
Lupus Erythematosus, Systemic - complications
Male
Medical prognosis
Medical sciences
Mortality
Myocarditis - etiology
Myocarditis - mortality
Myocarditis - pathology
Myocarditis. Cardiomyopathies
Patients
Population
Pregnancy
Pregnancy Complications - mortality
Prognosis
Proportional Hazards Models
Puerperal Disorders - mortality
Pulmonary arteries
Retrospective Studies
Scleroderma, Systemic - complications
Survival analysis
Survival Rate
Variables
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Summary:Lymphocytic myocarditis presents as a primary disorder or in association with a systemic disease. Whether primary and secondary myocarditis have the same prognosis is unknown. Patients (n = 171) referred to the Johns Hopkins Cardiomyopathy service from 1984 to 1998 with newly diagnosed cardiomyopathy were observed for an average of 5.9 years after an original diagnosis of biopsy-proven myocarditis or until reaching the end point of death. Giant-cell myocarditis was excluded from this study. Myocarditis was classified as secondary when a systemic disease was present at the time of presentation; otherwise, myocarditis was classified as primary. Survival rates among patients with primary and secondary myocarditis were compared with Kaplan-Meier analysis and Cox proportional hazard models incorporating clinical variables, including baseline hemodynamics and treatment with immunosuppressive therapy. The mortality rate associated with secondary myocarditis varied substantially depending on the underlying systemic disorder. Peripartum myocarditis, when compared with idiopathic myocarditis, had a reduced mortality rate (relative hazard, 0.23 [0.06–0.98]; P
ISSN:0002-8703
1097-6744
DOI:10.1016/j.ahj.2003.10.029