Non-steroidal anti-inflammatory drug use in acute myopericarditis : 12-month clinical follow-up
Objective: Clinical data on the effect of non-steroidal anti-inflammatory drugs (NSAIDs) in myopericarditis are limited. Since NSAIDs are standard therapy in pericarditis, we retrospectively investigated their safety in myopericarditis.
Methods: In a retrospective case-control study, we identified 60 patients with myopericarditis from September 2010 to August 2017. Diagnosis was based on clinical criteria, elevated high-sensitivity troponin T and cardiac magnetic resonance imaging (CMR). All patients received standard heart failure therapy if indicated. Twenty-nine patients (62%) received NSAIDs (acetylsalicylic acid: n=7, average daily dose =1300 mg or ibuprofen: n=22, average daily dose =1500 mg) for an average duration of 4 weeks. To create two cohorts with similar baseline conditions, 15 patients were excluded. Three months after diagnosis, 29 patients were re-evaluated by CMR to measure late gadolinium enhancement (LGE).
Results: Baseline characteristics of those treated with or without NSAIDs were similar. Mean age was 34 (±13) years, 6 (13%) were women. Mean left ventricular ejection fraction (LVEF) was 56% (±5). 82 % of the patients (14 of 17) treated with NSAIDs experienced a decrease in LGE at 3 months, while it was only 58 % (7 of 12) of those without NSAIDs (p=0.15). At 12-month follow-up, one of the patients treated without NSAIDs experienced polymorphic ventricular tachycardia (VT) with cardiac arrest, while one of the patients with NSAIDs experienced non-sustained VT.
Conclusions: This is the first case-control study demonstrating that NSAIDs are safe in patients with myopericarditis and preserved LVEF. Our data suggest that this drug class should be tested prospectively in a large randomised clinical trial.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2019 |
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| Erschienen: |
2019 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:6 |
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| Enthalten in: |
Open heart - 6(2019), 1 vom: 15., Seite e000990 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Berg, Jan [VerfasserIn] |
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| Links: |
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| Themen: |
Journal Article |
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| Anmerkungen: |
Date Revised 12.01.2021 published: Electronic-eCollection Citation Status PubMed-not-MEDLINE |
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| doi: |
10.1136/openhrt-2018-000990 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM297856715 |
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| 100 | 1 | |a Berg, Jan |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Non-steroidal anti-inflammatory drug use in acute myopericarditis |b 12-month clinical follow-up |
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| 500 | |a Citation Status PubMed-not-MEDLINE | ||
| 520 | |a Objective: Clinical data on the effect of non-steroidal anti-inflammatory drugs (NSAIDs) in myopericarditis are limited. Since NSAIDs are standard therapy in pericarditis, we retrospectively investigated their safety in myopericarditis | ||
| 520 | |a Methods: In a retrospective case-control study, we identified 60 patients with myopericarditis from September 2010 to August 2017. Diagnosis was based on clinical criteria, elevated high-sensitivity troponin T and cardiac magnetic resonance imaging (CMR). All patients received standard heart failure therapy if indicated. Twenty-nine patients (62%) received NSAIDs (acetylsalicylic acid: n=7, average daily dose =1300 mg or ibuprofen: n=22, average daily dose =1500 mg) for an average duration of 4 weeks. To create two cohorts with similar baseline conditions, 15 patients were excluded. Three months after diagnosis, 29 patients were re-evaluated by CMR to measure late gadolinium enhancement (LGE) | ||
| 520 | |a Results: Baseline characteristics of those treated with or without NSAIDs were similar. Mean age was 34 (±13) years, 6 (13%) were women. Mean left ventricular ejection fraction (LVEF) was 56% (±5). 82 % of the patients (14 of 17) treated with NSAIDs experienced a decrease in LGE at 3 months, while it was only 58 % (7 of 12) of those without NSAIDs (p=0.15). At 12-month follow-up, one of the patients treated without NSAIDs experienced polymorphic ventricular tachycardia (VT) with cardiac arrest, while one of the patients with NSAIDs experienced non-sustained VT | ||
| 520 | |a Conclusions: This is the first case-control study demonstrating that NSAIDs are safe in patients with myopericarditis and preserved LVEF. Our data suggest that this drug class should be tested prospectively in a large randomised clinical trial | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a late gadolinium enhancement | |
| 650 | 4 | |a magnetic resonance imaging | |
| 650 | 4 | |a myocardial inflammation | |
| 650 | 4 | |a myocarditis | |
| 650 | 4 | |a nonsteroidal anti-inflammatory drugs | |
| 700 | 1 | |a Lovrinovic, Marina |e verfasserin |4 aut | |
| 700 | 1 | |a Baltensperger, Nora |e verfasserin |4 aut | |
| 700 | 1 | |a Kissel, Christine K |e verfasserin |4 aut | |
| 700 | 1 | |a Kottwitz, Jan |e verfasserin |4 aut | |
| 700 | 1 | |a Manka, Robert |e verfasserin |4 aut | |
| 700 | 1 | |a Patriki, Dimitri |e verfasserin |4 aut | |
| 700 | 1 | |a Scherff, Frank |e verfasserin |4 aut | |
| 700 | 1 | |a Schmied, Christian |e verfasserin |4 aut | |
| 700 | 1 | |a Landmesser, Ulf |e verfasserin |4 aut | |
| 700 | 1 | |a Lüscher, Thomas F |e verfasserin |4 aut | |
| 700 | 1 | |a Heidecker, Bettina |e verfasserin |4 aut | |
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