34% of the patients with acute pericarditis have at least one adverse outcome, according to a research study conducted by Vecchié et al in a large urban hospital in the USA. The study further determines various factors that increase the risk of adverse outcomes associated with acute pericarditis.
It was a retrospective review that had implemented an informatics engine-based search. “Although patients with acute pericarditis respond well with the anti-inflammatory medicines, there may be various complications such as recurrence, tamponade, and constrictive pericarditis. There are certain adverse drug reactions and no well-established prognostic role of cardiac biomarkers”, wrote the authors. The authors further added, “The aim of the study was to analyze the clinical features that may result into adverse outcomes”.
The patients with pericardial diseases were searched through the informatics-based engine from the period January 1, 2009, and November 14, 2018. The patients who fulfilled the criteria of acute pericarditis as per the guidelines of the European Society of Cardiology criteria were included in the study. The study includes both the inpatients and outpatients. Echocardiograms of the patients were analyzed by at least two cardiologists before including them in the study. The cases with contradictory findings by the cardiologists were decided through discussion.
The primary aim of the study was to analyze the risk factors for the adverse outcomes of acute pericarditis such as treatment failure, tamponade, recurrence, constrictive pericarditis, and death.
A total of 240 patients were included in the study. The age range of the patients was 34 to 62 years with a median age of 51 years. 92% of the patients have chest pain, 18% have rubs, 47% have effusion while 53% suffer alterations in ECG. 35% of the patients have a history of cardiovascular disease while 20% have diabetes.
Troponin I measurement was available for 70% of the patients. When compared with the patients with non-troponin I measurement, the results suggest that it was measured either to exclude myocardial injury or for diagnosis. NSAIDs were used in 70.7% of the cases, colchicine in 63.6% of patients, and glucocorticoid was used in 12.2% of patients.
The median follow-up time at the study site was 179 days. 34.2% of patients experience at least one adverse outcome. 15.8% of patients experience recurrent pericarditis, 13% have tamponade, nine percent have constrictive pericarditis, and 7.2% suffer failure in treatment. The death occurred in 3.8% of patients.
The study concludes that acute pericarditis may cause adverse outcomes in 34% of the patients. Factors associated with higher incidences of adverse outcome include idiopathic etiology and subacute presentation. There was a reduced risk of recurrences in patients with elevated troponin I levels.