Out‐of‐Hospital Cardiac Arrest: Does a History of Myocarditis/Perimyocarditis Affect the Outcome? A Swedish Nationwide Study

Background Acute myocarditis/perimyocarditis presents with a variable prognosis ranging from complete recovery to end‐stage heart failure (HF), sudden cardiac arrest, and death. The relationship between a prior history of myocarditis/perimyocarditis and outcomes in out‐of‐hospital cardiac arrest rem...

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Main Authors: Sadek Nadhir, Marie Björkenstam, Emanuele Bobbio, Berkan Eken, Charlotta Ljungman, Christian Polte, Araz Rawshani, Entela Bollano
Format: Article
Language:English
Published: Wiley 2024-12-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
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Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.124.035763
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author Sadek Nadhir
Marie Björkenstam
Emanuele Bobbio
Berkan Eken
Charlotta Ljungman
Christian Polte
Araz Rawshani
Entela Bollano
author_facet Sadek Nadhir
Marie Björkenstam
Emanuele Bobbio
Berkan Eken
Charlotta Ljungman
Christian Polte
Araz Rawshani
Entela Bollano
author_sort Sadek Nadhir
collection DOAJ
description Background Acute myocarditis/perimyocarditis presents with a variable prognosis ranging from complete recovery to end‐stage heart failure (HF), sudden cardiac arrest, and death. The relationship between a prior history of myocarditis/perimyocarditis and outcomes in out‐of‐hospital cardiac arrest remains unclear. Methods and Results Using the SCRR (Swedish Cardiopulmonary Resuscitation Registry), we analyzed 54 568 cases of out‐of‐hospital cardiac arrest from 2010 to 2020 where cardiopulmonary resuscitation was attempted. Patients with a history of myocarditis/perimyocarditis were compared with those without in terms of characteristics and survival. Four hundred ninety‐eight patients (0.9%) had a history of myocarditis/perimyocarditis. These patients were predominantly men (73.8%), had an average age of 68 years, displayed a higher prevalence of cardiovascular comorbidities, and more frequently displayed shockable initial rhythms (28.7% versus 23.1%). Prior myocarditis/pericarditis did not correlate with worse short‐term (odds ratio [OR], 0.91 [95% CI, 0.61–1.33]) or long‐term survival (hazard ratio [HR], 1.01 [95% CI, 0.91–1.13]). Patients with myocarditis/perimyocarditis with concomitant HF showed worse long‐term survival in unadjusted analyses. Adjusted analyses confirmed that absence of HF was linked to improved short‐term survival (OR, 1.46 [95% CI, 1.32–1.62]), whereas prevalence of HF was a predictor for worsened long‐term survival (HR, 0.91 [95% CI, 0.91–0.95]) after out‐of‐hospital cardiac arrest. Analyses were adjusted for myocarditis/perimyocarditis, sex, age, HF, time to cardiopulmonary resuscitation start, and initial rhythm. Conclusions Prior myocarditis/perimyocarditis per se did not contribute to a worsened outcome following out‐of‐hospital cardiac arrest. However, the presence of concomitant HF was linked to unfavorable short‐ and long‐term outcomes.
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spelling doaj-art-3b7c6fb9dfae4ef2a3b6a5dd6dc04ebd2024-12-03T10:06:25ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-12-01132310.1161/JAHA.124.035763Out‐of‐Hospital Cardiac Arrest: Does a History of Myocarditis/Perimyocarditis Affect the Outcome? A Swedish Nationwide StudySadek Nadhir0Marie Björkenstam1Emanuele Bobbio2Berkan Eken3Charlotta Ljungman4Christian Polte5Araz Rawshani6Entela Bollano7Institute of Medicine Sahlgrenska Academy at the University of Gothenburg Gothenburg SwedenInstitute of Medicine Sahlgrenska Academy at the University of Gothenburg Gothenburg SwedenInstitute of Medicine Sahlgrenska Academy at the University of Gothenburg Gothenburg SwedenInstitute of Medicine Sahlgrenska Academy at the University of Gothenburg Gothenburg SwedenInstitute of Medicine Sahlgrenska Academy at the University of Gothenburg Gothenburg SwedenInstitute of Medicine Sahlgrenska Academy at the University of Gothenburg Gothenburg SwedenInstitute of Medicine Sahlgrenska Academy at the University of Gothenburg Gothenburg SwedenInstitute of Medicine Sahlgrenska Academy at the University of Gothenburg Gothenburg SwedenBackground Acute myocarditis/perimyocarditis presents with a variable prognosis ranging from complete recovery to end‐stage heart failure (HF), sudden cardiac arrest, and death. The relationship between a prior history of myocarditis/perimyocarditis and outcomes in out‐of‐hospital cardiac arrest remains unclear. Methods and Results Using the SCRR (Swedish Cardiopulmonary Resuscitation Registry), we analyzed 54 568 cases of out‐of‐hospital cardiac arrest from 2010 to 2020 where cardiopulmonary resuscitation was attempted. Patients with a history of myocarditis/perimyocarditis were compared with those without in terms of characteristics and survival. Four hundred ninety‐eight patients (0.9%) had a history of myocarditis/perimyocarditis. These patients were predominantly men (73.8%), had an average age of 68 years, displayed a higher prevalence of cardiovascular comorbidities, and more frequently displayed shockable initial rhythms (28.7% versus 23.1%). Prior myocarditis/pericarditis did not correlate with worse short‐term (odds ratio [OR], 0.91 [95% CI, 0.61–1.33]) or long‐term survival (hazard ratio [HR], 1.01 [95% CI, 0.91–1.13]). Patients with myocarditis/perimyocarditis with concomitant HF showed worse long‐term survival in unadjusted analyses. Adjusted analyses confirmed that absence of HF was linked to improved short‐term survival (OR, 1.46 [95% CI, 1.32–1.62]), whereas prevalence of HF was a predictor for worsened long‐term survival (HR, 0.91 [95% CI, 0.91–0.95]) after out‐of‐hospital cardiac arrest. Analyses were adjusted for myocarditis/perimyocarditis, sex, age, HF, time to cardiopulmonary resuscitation start, and initial rhythm. Conclusions Prior myocarditis/perimyocarditis per se did not contribute to a worsened outcome following out‐of‐hospital cardiac arrest. However, the presence of concomitant HF was linked to unfavorable short‐ and long‐term outcomes.https://www.ahajournals.org/doi/10.1161/JAHA.124.035763myocarditisout‐of‐hospital cardiac arrestperimyocarditissurvival
spellingShingle Sadek Nadhir
Marie Björkenstam
Emanuele Bobbio
Berkan Eken
Charlotta Ljungman
Christian Polte
Araz Rawshani
Entela Bollano
Out‐of‐Hospital Cardiac Arrest: Does a History of Myocarditis/Perimyocarditis Affect the Outcome? A Swedish Nationwide Study
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
myocarditis
out‐of‐hospital cardiac arrest
perimyocarditis
survival
title Out‐of‐Hospital Cardiac Arrest: Does a History of Myocarditis/Perimyocarditis Affect the Outcome? A Swedish Nationwide Study
title_full Out‐of‐Hospital Cardiac Arrest: Does a History of Myocarditis/Perimyocarditis Affect the Outcome? A Swedish Nationwide Study
title_fullStr Out‐of‐Hospital Cardiac Arrest: Does a History of Myocarditis/Perimyocarditis Affect the Outcome? A Swedish Nationwide Study
title_full_unstemmed Out‐of‐Hospital Cardiac Arrest: Does a History of Myocarditis/Perimyocarditis Affect the Outcome? A Swedish Nationwide Study
title_short Out‐of‐Hospital Cardiac Arrest: Does a History of Myocarditis/Perimyocarditis Affect the Outcome? A Swedish Nationwide Study
title_sort out of hospital cardiac arrest does a history of myocarditis perimyocarditis affect the outcome a swedish nationwide study
topic myocarditis
out‐of‐hospital cardiac arrest
perimyocarditis
survival
url https://www.ahajournals.org/doi/10.1161/JAHA.124.035763
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