Abstract 4146540: Clinical characteristics and mortality outcomes in a multi-ethnic cohort of Asian patients with myocarditis

Background: Myocarditis is an inflammatory disease of the myocardium associated with numerous adverse outcomes such as arrhythmias, heart failure, cardiac arrest as well as death. Clinical characteristics and mortality outcome data in myocarditis specific to Asian patients is limited. Research Question: To evaluate characteristics and mortality outcome amongst a multi-ethnic cohort of Asian patients diagnosed with myocarditis. Methods: This retrospective, single-center cohort study involved consecutive patients diagnosed with myocarditis between 2010 and 2021 in a tertiary academic center. Patient respective clinical profile, diagnostic results and outcomes were detailed. Categorical variables were compared between mortality groups using the chi-squared test, and continuous variables with t-tests or Mann-Whitney U tests. Results: A total of 203 patients (mean age 41.8, 40.9% female) diagnosed with myocarditis were included in the study. The prevalence of fulminant myocarditis, acute non-fulminant myocarditis and chronic inflammatory cardiomyopathy in this cohort was 31%, 67.2% and 5.5% respectively. Over a mean follow up period of 4.7 years (SD 3.5), the all-cause mortality was 17.7% (36 patients) (p=<0.001). The mortality was higher amongst female patients as compared to male patients (21.6% vs 15%; p=0.299) and the mean age was higher amongst patients that suffered from all-cause mortality (48.14 vs 40.43; p=0.036). In terms of aetiology, viral myocarditis constituted the highest proportion overall (n=100; 49%) as well as within the mortality group (n=15; 41%). The overall prevalence of chronic kidney disease, hypertension and diabetes mellitus was 5.4%, 31.5%, and 15.8% respectively. In comparison to the survival group, the mortality group had a higher prevalence of chronic kidney disease (30.6% vs 12.6%; p=0.015), hypertension (47.2% vs 28.1%; p=0.042) and diabetes mellitus (16.7% vs 3.0%; p=0.004). In terms of medication usage, compared to the survival group, the mortality group had higher usage of B-blocker (13.9% vs 5.4%; p=0.144), ACE-i/ARB (13.9% vs 10.8%; p=0.807), statin therapy (22% vs 7.2%; p=0.015), anti-diabetic medications (25% vs 12%; p=0.078),and single/dual anti-platelet therapy (13.9% vs 4.8%; p=0.1). Conclusions: In a multi-ethnic Asian population, increased age, female gender, hypertension, chronic kidney disease, and diabetes mellitus were associated with worse outcomes.