ST-segment elevation in acute pericarditis and myocardial involvement: electrocardiographic and clinical profiling.

ST-elevation was present in 34.5% of pericarditis patients and predicted myocardial involvement with an odds ratio of 1.82.

• 121 of 351 patients (34.5%) had ST-elevation.
• ST-elevation predicted myocardial involvement with an OR of 1.82 (95% CI 1.07 to 3.10).
• Myocardial involvement occurred more frequently among those with ST-elevation: 26.4% (32/121) compared with those without: 16.5% (38/230) (p=0.035).
• Myocardial involvement was defined by troponin elevation and/or suggestive cardiac MRI findings.

Patients with ST-elevation were younger, more often male, had higher CRP values, and less frequent pericardial effusions compared to those without ST-elevation.

• ST-elevation patients were younger: median 38 years (IQR 23-53) vs 47 years (IQR 31-58) (p<0.001).
• ST-elevation patients were more often male: 63.6% (77/121) vs 40.9% (94/230) (p<0.001).
• ST-elevation patients had higher C-reactive protein values: 92.0 (IQR 35-170) vs 58.4 mg/L (IQR 15.8-137.5) (p=0.002).
• ST-elevation patients had less frequent pericardial effusions: 71.1% (86/121) vs 83.5% (192/230) (p=0.004).

Myocardial involvement was diagnosed in 19.9% of the total pericarditis cohort.

• 70 of 351 patients (19.9%) were diagnosed with myopericarditis.
• The study included 351 pericarditis patients, of whom 328 had recurrent pericarditis and 180 were female.
• Myocardial involvement was defined by troponin elevation and/or suggestive cardiac MRI.

Compared with isolated pericarditis, myopericarditis patients were more frequently male and had a higher prevalence of transient systolic dysfunction.

• Myopericarditis patients were more frequently male: 61.4% (43/70) vs 45.6% (128/281) (p=0.023).
• Transient systolic dysfunction was more prevalent in myopericarditis patients: 13.5% (7/52) vs 2.1% (3/141) (p=0.004).

Myopericarditis was associated with lower remission rates and higher annual hospitalisation rates compared to isolated pericarditis, despite comparable recurrence rates and treatment strategies.

• Myopericarditis patients had a lower remission rate: 18.5% (12/65) vs 31.2% (82/263) (p=0.047).
• Myopericarditis patients had a higher annual hospitalisation rate: median 0.5 vs 0.4 per year (p=0.010).
• Recurrence rates and disease duration were similar between myopericarditis and isolated pericarditis groups.
• Treatment strategies, including use of corticosteroids and interleukin-1 blockers, were comparable between groups.