%0 Journal Article
%T Age-stratified patterns in clinical presentation, treatment and outcomes in acute pericarditis: a retrospective cohort study.
%A Collini V
%A Siega Vignut L
%A Angriman F
%A Braidotti G
%A De Biasio M
%A Imazio M
%J Heart
%V 0
%N 0
%D 2024 Jun 26
%M 38925882
%F 7.365
%R 10.1136/heartjnl-2024-324214
%X <B>BACKGROUND: </B>There are limited data on acute pericarditis according to different age groups. The aim of this study is to investigate the role of age-related features in clinical characteristics, management, and outcomes of acute pericarditis, with a focus on the geriatric population.<BR><B>METHODS: </B>Patients with a first episode of acute pericarditis were consecutively enrolled between January 2014 and June 2022, and divided into four groups according to age (G1: 18-35 years; G2: 35-55 years; G3: 55-75 years; G4: >75 years). Clinical characteristics and medical therapy were recorded at baseline, and during follow-up.<BR><B>RESULTS: </B>A total of 471 patients (median age 56.3 (IQR 33-73) years, 32.3% women) were included. Younger age (G1-G2-G3) was associated with a higher frequency of chest pain, pericardial rubs (p<0001), ECG changes (p=0.002) and were more commonly treated with colchicine (p<0.001), and non-steroidal anti-inflammatory drugs (p=0.006). Older patients (G4) depicted more commonly dyspnoea, pericardial/pleural effusion (p=0.007) and were more often treated with corticosteroids (p=0.037). A secondary cause of pericarditis was detected in 128/471 (27.2%) patients. Older patients were more commonly hospitalised and had a complicated course with new-onset atrial fibrillation (p<0.001) and cardiac tamponade (p=0.005), compared with younger patients, who presented more recurrences (respectively G1: 43.0%, G2: 34.7%, G3: 28.2% and G4: 16.2%; p<0.001). After multivariable analysis, younger age remained the strongest independent predictor for recurrences (HR 3.23, 95% CI 1.81 to 5.58, p<0.001).<BR><B>CONCLUSIONS: </B>Older age is associated with less recurrences of pericarditis, but more severe complications with need for hospitalisation.