Nationwide Trends in Idiopathic Pericarditis Management and Outcomes in Japan - A Nationwide JROAD-DPC Analysis.

Abstract

Background: Idiopathic pericarditis generally has a favorable prognosis, but contemporary data on treatment patterns and outcomes remain limited.

Methods and results: Using a nationwide Japanese database, we analyzed 8,020 pericarditis patients hospitalized between April 2016 and March 2021, and identified 3,963 (49%) patients with idiopathic pericarditis after excluding those with infectious, autoimmune or other causes. During the study period, the median age increased from 62 to 68 years (P_trend<0.001), and prescription rates of non-steroidal anti-inflammatory drugs (NSAIDs) and colchicine, and the simultaneous administration of NSAIDs and colchicine increased over time (from 65.9 to 72.6% [P=0.049], from 17.4 to 44.3% [P<0.001], and from 8.0 to 22.7% [P<0.001], respectively). The mean incidence of in-hospital death and rehospitalization for recurrence was 1.4% and 5.7%, respectively; neither changed over time. The mean length of hospitalization increased from 8 to 10 days and the cost of hospitalization increased from JPY 417,000 to JPY 525,000. Multivariable analysis showed that age and steroid use were significant predictors of in-hospital death, whereas cardiac tamponade was not (adjusted odds ratio 1.32; 95% confidence interval 0.56-3.14).

Conclusions: Among hospitalized patients with idiopathic pericarditis, prescription rates of medications recommended by European Society of Cardiology guidelines have increased, although the concurrent use of NSAIDs and colchicine remains uncommon; there have been no changes in the incidence of in-hospital death. Prospective studies, including outpatients, are needed to clarify the prognosis and recurrence rate of idiopathic pericarditis.