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. 2019 Aug 19;4(3):247-256.
doi: 10.1080/20961790.2019.1595352. eCollection 2019.

Sudden cardiac death caused by myocarditis in persons aged 1-49 years: a nationwide study of 14 294 deaths in Denmark

Thomas Hadberg Lynge  1 , Trine Skov Nielsen  2 , Bo Gregers Winkel  1 , Jacob Tfelt-Hansen  1   3 , Jytte Banner  3
Affiliations

Sudden cardiac death caused by myocarditis in persons aged 1-49 years: a nationwide study of 14 294 deaths in Denmark

Thomas Hadberg Lynge et al. Forensic Sci Res. .

Abstract

Myocarditis is associated with an increased risk of sudden cardiac death (SCD) in the young. However, information on nationwide burden of SCD caused by myocarditis (SCD-myocarditis) is sparse. For this study all deaths among persons in Denmark aged 1-35 years in 2000-2009 and 36-49 years in 2007-2009 (27.1 million person-years) were included. Autopsy reports, death certificates, discharge summaries, and nationwide registries were used to identify all cases of SCD-myocarditis. In the 10-year study period, there were 14 294 deaths, of which we identified 1 363 (10%) SCD. Among autopsied SCD (n = 753, 55%), cause of death was myocarditis in 42 (6%) cases corresponding to an SCD-myocarditis incidence of 0.16 (95%CI: 0.11-0.21) per 100 000 person-years. Males had significantly higher incidence rates of SCD-myocarditis compared to females with an incidence rate ratio of 2.2 (95%CI: 1.1-4.1). Myocarditis was not registered as cause of death in any of the non-autopsied SCD (n = 610, 45%). In conclusion, after nationwide unselected inclusion of 14 294 deaths, we found that 6% of all autopsied SCD was caused by myocarditis. No cases of SCD-myocarditis were reported in the non-autopsied SCD, which could reflect underdiagnosing of myocarditis in non-autopsied SCD. Furthermore, our data suggest a female protection towards SCD-myocarditis.

Keywords: Forensic sciences; autopsy; children; epidemiology; gender; myocarditis; sudden cardiac death; young adults.

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Figures

Figure 1.
Figure 1.
Flowchart of the process used to identify all cases of sudden cardiac death caused by myocarditis in persons aged 1–35 years and 1–49 years during 2000–2006 and 2007–2009, respectively.
Figure 2.
Figure 2.
Age-related distribution of incidence of sudden cardiac death (SCD) caused by myocarditis per 100 000 person-years in persons aged 1–49 years in Denmark.
Figure 3.
Figure 3.
Sex-specific age-related distribution of incidence of sudden cardiac death (SCD) caused by myocarditis per 100 000 person-years in persons aged 1–49 years in Denmark.
See this image and copyright information in PMC

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References

    1. Sagar S, Liu PP, Cooper LT. Myocarditis. Lancet 2012;379:738–747. - PMC - PubMed
    1. Caforio ALP, Malipiero G, Marcolongo R, et al. . Myocarditis: a clinical overview. Curr Cardiol Rep. 2017;19:63. - PubMed
    1. Caforio ALP, Pankuweit S, Arbustini E, et al. . Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J. 2013;34:2636–2648. - PubMed
    1. Hufnagel G, Pankuweit S, Richter A, et al. . The European Study of Epidemiology and Treatment of Cardiac Inflammatory Diseases (ESETCID). First epidemiological results. Herz. 2000;25:279–285. - PubMed
    1. Kindermann I, Kindermann M, Kandolf R, et al. . Predictors of outcome in patients with suspected myocarditis. Circulation. 2008;118:639–648. - PubMed

Grants and funding

This work was supported by Novo Nordisk Foundation, Copenhagen, Denmark [grant number NNFOC140011573]; The Heart Centre, Department of Cardiology, University Hospital Rigshospitalet, Copenhagen, Denmark; Section of Forensic Pathology, Department of Forensic Medicine, Aarhus University, Denmark; Section of Forensic Pathology, Department of Forensic Medicine Copenhagen University, Denmark; and Rigshospitalets Forskningspuljer, Rigshospitalet, Copenhagen, Denmark.