1. Pericarditis Recurrence After Initial Uncomplicated Clinical Course
- Author
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Alessandra Vecchié, Benjamin W. Van Tassell, Georgia K. Thomas, Daniel Berrocal, Aldo Bonaventura, Juan Guido Chiabrando, Marco Giuseppe Del Buono, Tamas S Gal, Megan Dell, Travis Oakes, Juan Ignacio Damonte, and Antonio Abbate
- Subjects
Adult ,Male ,medicine.medical_specialty ,Logistic regression ,Severity of Illness Index ,Pericardial effusion ,Pericardial Effusion ,Article ,Pericarditis ,Postoperative Complications ,Acute pericarditis ,Adrenal Cortex Hormones ,Recurrence ,Risk Factors ,Interquartile range ,Internal medicine ,medicine ,Humans ,Retrospective Studies ,First episode ,business.industry ,Incidence (epidemiology) ,Anti-Inflammatory Agents, Non-Steroidal ,Age Factors ,Middle Aged ,medicine.disease ,Tubulin Modulators ,Surgery ,Logistic Models ,Acute Disease ,Multivariate Analysis ,Cardiology ,Female ,Tamponade ,Colchicine ,Cardiology and Cardiovascular Medicine ,business - Abstract
Acute pericarditis is an inflammatory disease associated with a non-negligible risk of acute complications and future recurrence. However, the exact incidence of pericarditis recurrence in patients with a first uncomplicated clinical course is unknown. We sought to evaluate the incidence and clinical predictors of recurrence after a first episode of acute uncomplicated pericarditis in a large urban hospital in the United States. We conducted a retrospective review, through electronic health records, to complete a database that includes patients admitted with a first episode of acute pericarditis and selected only those with an uncomplicated course (without in-hospital death, large pericardial effusion [>20 mm] or tamponade, constriction, or incessant pericarditis) at the VCU Medical Center (Richmond, Virginia) from 2009 to 2018. A total of 240 patients met acute pericarditis criteria: of the 240 patients, 164 patients (68%) had an uncomplicated course (median age [interquartile range] in years: 50 [32 to 62], 43% females). The median follow-up time was 186 (19 to 467) days. Pericarditis was idiopathic in 84 patients (51%). Fifteen patients (9%) had at least 1 episode of recurrent pericarditis. Compared with those without recurrence, patients with recurrent pericarditis were younger (37 [25 to 59] vs 51 [34 to 62] years, p = 0.034), had a higher prevalence of subacute/delayed presentation (2 [13%] vs 1 [1%], p = 0.023), and less frequently received colchicine (6 [40%] vs 100 [67%], p = 0.036). At multivariate logistic regression analysis, subacute presentation and younger age remained predictors of recurrence at follow-up. In conclusion, 9% of patients with acute pericarditis experienced a recurrence over a 6-month median follow-up despite an initial uncomplicated course. Younger age and subacute presentation were associated with a significantly increased risk of recurrence.
- Published
- 2021