Kang TD, Ren YL, Zhao H, Ning SQ, Liu WX. Risk factors for adverse cardiac events in adults with fulminant myocarditis during hospitalization. World J Clin Cases 2020; 8(2): 255-263 [PMID: 32047773 DOI: 10.12998/wjcc.v8.i2.255]
Corresponding Author of This Article
Wen-Xian Liu, MD, Chief Physician, Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Lab for Cardiovascular Precision Medicine, No. 2, Anzhen Road, Chaoyang District, Beijing 100029, China. 18911662882@163.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Case Control Study
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Kang TD, Ren YL, Zhao H, Ning SQ, Liu WX. Risk factors for adverse cardiac events in adults with fulminant myocarditis during hospitalization. World J Clin Cases 2020; 8(2): 255-263 [PMID: 32047773 DOI: 10.12998/wjcc.v8.i2.255]
World J Clin Cases. Jan 26, 2020; 8(2): 255-263 Published online Jan 26, 2020. doi: 10.12998/wjcc.v8.i2.255
Risk factors for adverse cardiac events in adults with fulminant myocarditis during hospitalization
Tie-Duo Kang, Yan-Long Ren, Han Zhao, Shang-Qiu Ning, Wen-Xian Liu
Tie-Duo Kang, Yan-Long Ren, Han Zhao, Shang-Qiu Ning, Wen-Xian Liu, Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Lab for Cardiovascular Precision Medicine, Beijing 100029, China
Author contributions: Kang TD, Ren YL, and Zhao H contributed equally to this article; Liu WX and Ren YL conceived of the study; Zhao H and Ren YL performed the statistical analysis and drafted the manuscript; Ning SQ and Kang TD collected the clinical data and participated in the design of the study; Ren YL and Kang TD helped to revise the manuscript; all authors read and approved the final manuscript.
Supported byBeijing Natural Science Foundation, No. 7184205; Beijing Talents Fund, No. 2017000021469G224; Foundation of Beijing Anzhen Hospital, Capital Medical University, No. 2016Z07.
Institutional review board statement: The study was conducted in accordance with the Declaration of Helsinki and approved by the Clinical Research Ethics Board of Beijing Anzhen Hospital, Capital Medical University (approval number: 2019021X).
Informed consent statement: All subjects provided written informed consent.
Conflict-of-interest statement: The authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Data sharing statement: There are no additional data.
STROBE statement: The manuscript was revised according to the STROBE statement.
Corresponding author: Wen-Xian Liu, MD, Chief Physician, Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Lab for Cardiovascular Precision Medicine, No. 2, Anzhen Road, Chaoyang District, Beijing 100029, China. 18911662882@163.com
Received: September 6, 2019 Peer-review started: September 6, 2019 First decision: November 12, 2019 Revised: November 29, 2019 Accepted: December 21, 2019 Article in press: December 21, 2019 Published online: January 26, 2020 Processing time: 133 Days and 3.7 Hours
ARTICLE HIGHLIGHTS
Research background
Fulminant myocarditis is the critical form of myocarditis often associated with heart failure, malignant arrhythmia, and circulatory failure. Patients with fulminant myocarditis who end up with severe multiple organic failure and death are not rare.
Research objectives
In this study, the authors aimed to analyze the predictors of in-hospital major adverse cardiovascular events (MACE) in patients diagnosed with fulminant myocarditis.
Research methods
The authors built a cohort of adult patients diagnosed with fulminant myocarditis. The primary endpoint was defined as in-hospital MACE, including death, cardiac arrest, cardiac shock, and ventricular fibrillation. Baseline demographics, clinical history, characteristics of electrocardiograph and ultrasonic cardiogram, laboratory examination, and treatment were recorded.
Research results
The rate of in-hospital MACE was 40%. Multivariable logistic regression analysis demonstrated that baseline QRS duration > 120 ms was an independent risk factor for in-hospital MACE. The area under curve of QRS duration > 120 ms for predicting in-hospital MACE was 0.683.
Research conclusions
The onset of outbreak myocarditis is acute, and the incidence of MACE is higher in female patients during hospitalization. QRS broadening in baseline electrocardiogram (QRS > 120 ms) is an independent risk factor for the occurrence of MACE in outbreak myocarditis patients during hospitalization.
Research perspectives
Baseline QRS width has predictive value for the occurrence of MACE in outbreak myocarditis patients during hospitalization. Patients with these characteristics should be treated actively as soon as possible in clinic, and mechanical support should be given when necessary, in order to improve the prognosis of patients.
