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Age‐ and sex‐based differences in patients with acute pericarditis
Author(s) -
Lazaros George,
Antonopoulos Alexios S.,
Lazarou Emilia,
Vlachopoulos Charalambos,
Vogiatzi Georgia,
Vassilopoulos Dimitrios,
Tousoulis Dimitris
Publication year - 2021
Publication title -
european journal of clinical investigation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.164
H-Index - 107
eISSN - 1365-2362
pISSN - 0014-2972
DOI - 10.1111/eci.13392
Subject(s) - medicine , pericarditis , acute pericarditis , atrial fibrillation , chest pain , pericardial effusion , hazard ratio , depression (economics) , demographics , cardiology , surgery , confidence interval , macroeconomics , demography , sociology , economics
Abstract Background Acute pericarditis has a wide spectrum of clinical presentations largely depending on underlying aetiologies. We assessed the role of age and sex in the clinical features and outcome of acute pericarditis. Materials and methods A total of 240 consecutive patients hospitalized with a first episode of acute pericarditis were included. At baseline demographics, clinical features, laboratory and imaging findings and medical therapy were recorded. Patients were followed up for at least 18 months for complications. Data comparisons were performed according to sex and age (≤60 or >60 years). Results The male/female ratio was 1.42, and 56% of patients were >60 years. Younger patients depicted more often chest pain ( P = .001), fever and rubs ( P < .001 for both), ST elevation and PR depression ( P = .032 and .009, respectively), higher CRP values ( P = .009) and less often dyspnoea ( P = .046) and pericardial effusion ( P = .036). Moreover, they received less often glucocorticoids ( P < .001) and depicted less atrial fibrillation ( P = .003) and a higher rate of recurrent pericarditis ( P = .013). After multivariate adjustment for confounders, age >60 years remained an independent predictor for a lower risk of recurrent pericarditis (hazard ratio 0.60, 95% CI: 0.39‐0.96, P = .033). Regarding sex, females were older ( P = .007), showed less often ST elevation and PR depression ( P < .001 and .002, respectively) and had a higher baseline heart rate ( P = .02). Sex was not associated with recurrent pericarditis risk. Conclusions Patients with acute pericarditis have distinct presenting clinical, biochemical and prognostic features according to age and sex. Awareness of such differences is important for clinical decision‐making.