Journal Article

Age-stratified patterns in clinical presentation, treatment and outcomes in acute pericarditis: a retrospective cohort study

Collini, Valentino, Angriman, Federico, Braidotti, Gioia, Imazio, Massimo, Siega Vignut, Luca, De Biasio, Marzia

2024

Overview

BackgroundThere are limited data on acute pericarditis according to different age groups. The aim of this study is to investigate the role of age-related features in clinical characteristics, management, and outcomes of acute pericarditis, with a focus on the geriatric population.MethodsPatients with a first episode of acute pericarditis were consecutively enrolled between January 2014 and June 2022, and divided into four groups according to age (G1: 18–35 years; G2: 35–55 years; G3: 55–75 years; G4: >75 years). Clinical characteristics and medical therapy were recorded at baseline, and during follow-up.ResultsA total of 471 patients (median age 56.3 (IQR 33–73) years, 32.3% women) were included. Younger age (G1-G2-G3) was associated with a higher frequency of chest pain, pericardial rubs (p<0001), ECG changes (p=0.002) and were more commonly treated with colchicine (p<0.001), and non-steroidal anti-inflammatory drugs (p=0.006). Older patients (G4) depicted more commonly dyspnoea, pericardial/pleural effusion (p=0.007) and were more often treated with corticosteroids (p=0.037). A secondary cause of pericarditis was detected in 128/471 (27.2%) patients. Older patients were more commonly hospitalised and had a complicated course with new-onset atrial fibrillation (p<0.001) and cardiac tamponade (p=0.005), compared with younger patients, who presented more recurrences (respectively G1: 43.0%, G2: 34.7%, G3: 28.2% and G4: 16.2%; p<0.001). After multivariable analysis, younger age remained the strongest independent predictor for recurrences (HR 3.23, 95% CI 1.81 to 5.58, p<0.001).ConclusionOlder age is associated with less recurrences of pericarditis, but more severe complications with need for hospitalisation.

• Publisher: BMJ Publishing Group Ltd and British Cardiovascular Society,BMJ Publishing Group LTD
• Subject: Acute Disease / Adolescent / Adult / Age Factors / Age groups / Aged / cardiac tamponade / Cardiology / Colchicine - therapeutic use / Drug dosages / Dyspnea / Electrocardiography / Female / Geriatrics / Humans / Industrialized nations / Male / Medical diagnosis / Middle Aged / Older people / Pericarditis / Pericarditis - diagnosis / Pericarditis - drug therapy / Pericarditis - epidemiology / Pericarditis - therapy / pericarditis, constrictive / Population / Recurrence / Retrospective Studies / Special populations / Steroids / Treatment Outcome / Young Adult