RT Journal Article
SR Electronic
T1 Non-steroidal anti-inflammatory drug use in acute myopericarditis: 12-month clinical follow-up
JF Open Heart
JO Open Heart
FD British Cardiovascular Society
SP e000990
DO 10.1136/openhrt-2018-000990
VO 6
IS 1
A1 Jan Berg
A1 Marina Lovrinovic
A1 Nora Baltensperger
A1 Christine K Kissel
A1 Jan Kottwitz
A1 Robert Manka
A1 Dimitri Patriki
A1 Frank Scherff
A1 Christian Schmied
A1 Ulf Landmesser
A1 Thomas F Lüscher
A1 Bettina Heidecker
YR 2019
UL http://openheart.bmj.com/content/6/1/e000990.abstract
AB 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.