national trends of Acute Pericarditis post atrial fibrillation ablation

BACKGROUND Atrial fibrillation ablation increased over the last two decades by its high success rate. However, the trend of inpatient adverse outcomes is limited. The aim of this study to examine the frequency and predictors of Acute Pericarditis resulting from catheter ablation. METHODS Using the National Inpatient Sample, we identified all patients who underwent AF ablation. Univariate and multivariate logistic regressions were performed for the primary outcome of in-hospital Acute Pericarditis post-AF ablation. Variance-weighted regression has been used to test for linear and curvilinear trends in disease characteristics and outcomes over time. RESULTS From 2002 to 2014, our study included 122,993 patients, Acute Pericarditis was found in 984 (0.8%) patients who underwent AF ablation. The trend of Acute Pericarditis showed inconsistent fluctuation leaning towards reduction over the years. Multivariate analysis showed that patients of female gender are at a 40% higher risk of Acute Pericarditis post-ablation compared with males. Additionally, obese patients have a 40% higher risk of developing Acute Pericarditis compared with patients who have BMI < 30. Furthermore, anaemia and rheumatoid arthritis have the odds ratio (OR: 2.63; 95% [CI] 2.04-3.39) and (OR: 1.64; 95% [CI] 1.08-2.48). CONCLUSION Post-AF ablation, in-hospital Acute Pericarditis showed inconsistent fluctuation leaning towards reduction. Female gender and obesity are at higher risk for developing Acute Pericarditis post-AF ablations. Proper evaluation might alter those complications.

National trends of Acute Pericarditis post‐atrial fibrillation ablation

BACKGROUND Atrial fibrillation ablation increased over the last two decades by its high success rate. However, the trend of inpatient adverse outcomes is limited. The aim of this study to examine the frequency and predictors of Acute Pericarditis resulting from catheter ablation. METHODS Using the National Inpatient Sample, we identified all patients who underwent AF ablation. Univariate and multivariate logistic regressions were performed for the primary outcome of in-hospital Acute Pericarditis post-AF ablation. Variance-weighted regression has been used to test for linear and curvilinear trends in disease characteristics and outcomes over time. RESULTS From 2002 to 2014, our study included 122,993 patients, Acute Pericarditis was found in 984 (0.8%) patients who underwent AF ablation. The trend of Acute Pericarditis showed inconsistent fluctuation leaning towards reduction over the years. Multivariate analysis showed that patients of female gender are at a 40% higher risk of Acute Pericarditis post-ablation compared with males. Additionally, obese patients have a 40% higher risk of developing Acute Pericarditis compared with patients who have BMI 

Acute Pericarditis: Management Overview

Acute Pericarditis is the most common pericardial syndrome that is encountered in clinical practice. It is an inflammatory pericardial syndrome with or without pericardial effusion [1, 2].

Colchicine for Acute Pericarditis. Results from the Investigation on Colchicine in Acute Pericarditis (ICAP). A prospective, randomized, double-blind, placebo-controlled, multicenter trial

Purpose: Despite a large amount of data on recurrent Pericarditis, conclusive data are lacking to demonstrate the efficacy and safety of colchicine for the treatment of the first attack of Acute Pericarditis. The Investigation on Colchicine in Acute Pericarditis (ICAP) trial is a prospective, randomized, double-blind, placebo-controlled, multicenter trial aimed at the evaluation of the efficacy and safety of colchicine to treat Acute Pericarditis and prevent its recurrences.

Methods: Eligible adult patients with Acute Pericarditis were randomly assigned to placebo or colchicine (0.5 mg twice daily for 3 months for patients>70kg or 0.5 mg once daily if ≤70kg) in addition to conventional anti-inflammatory therapy with aspirin or ibuprofen in a multicenter, double-blind, placebo-controlled trial. The primary study outcome was incessant/recurrent Pericarditis within 18 months. Secondary outcomes were symptoms persistence at 72 hours, remission within 1 week, number of recurrences, time to first recurrence, disease-related hospitalization, cardiac tamponade, and constrictive Pericarditis.

Results: Of the 240 randomly assigned participants (mean age 52.1±16.9 years, 60% males), 65 patients (27.1%) reached the primary outcome: incessant/recurrent Pericarditis within 18 months was 16.7% in the colchicine group and 37.5% in the placebo group (relative risk reduction 0.56 95% CI 0.30-0.72; number needed to treat-NNT 4). Colchicine reduced symptoms persistence at 72 hours (respectively, 19.2% vs. 40.0%; p=0.001), number of recurrences, hospitalizations (respectively, 5.0% vs. 14.2%; p=0.016), improved the remission rate at 1 week (respectively, 85.0% vs. 58.3%; p

colchicine for Acute Pericarditis results from the investigation on colchicine in Acute Pericarditis icap a prospective randomized double blind placebo controlled multicenter trial

Purpose: Despite a large amount of data on recurrent Pericarditis, conclusive data are lacking to demonstrate the efficacy and safety of colchicine for the treatment of the first attack of Acute Pericarditis. The Investigation on Colchicine in Acute Pericarditis (ICAP) trial is a prospective, randomized, double-blind, placebo-controlled, multicenter trial aimed at the evaluation of the efficacy and safety of colchicine to treat Acute Pericarditis and prevent its recurrences.

Methods: Eligible adult patients with Acute Pericarditis were randomly assigned to placebo or colchicine (0.5 mg twice daily for 3 months for patients>70kg or 0.5 mg once daily if ≤70kg) in addition to conventional anti-inflammatory therapy with aspirin or ibuprofen in a multicenter, double-blind, placebo-controlled trial. The primary study outcome was incessant/recurrent Pericarditis within 18 months. Secondary outcomes were symptoms persistence at 72 hours, remission within 1 week, number of recurrences, time to first recurrence, disease-related hospitalization, cardiac tamponade, and constrictive Pericarditis.

Results: Of the 240 randomly assigned participants (mean age 52.1±16.9 years, 60% males), 65 patients (27.1%) reached the primary outcome: incessant/recurrent Pericarditis within 18 months was 16.7% in the colchicine group and 37.5% in the placebo group (relative risk reduction 0.56 95% CI 0.30-0.72; number needed to treat-NNT 4). Colchicine reduced symptoms persistence at 72 hours (respectively, 19.2% vs. 40.0%; p=0.001), number of recurrences, hospitalizations (respectively, 5.0% vs. 14.2%; p=0.016), improved the remission rate at 1 week (respectively, 85.0% vs. 58.3%; p<0.001), and prolonged time to first recurrence. Corticosteroid use (OR 4.17, 95% CI 1.28 to 13.53; p=0.018), and C-reactive protein elevation at presentation (OR 3.15, 95% CI 1.05 to 9.49; p=0.041) were independent risk factors for recurrences in multivariable analysis. Overall adverse effect rates were similar in the study groups (respectively, 11.7% in the colchicine group and 10.0% in the placebo group; p=0.836) as well as withdrawal rates (respectively, 11.7% vs. 8.3%; p=0.519). No serious adverse effects were observed. Conclusions: The ICAP trial is the first multicenter, double-blind, randomized trial to show the efficacy and safety of colchicine as an adjunct to conventional anti-inflammatory therapy to halve incessant/recurrent Pericarditis within 18 months, reduce the number of recurrences, and prolong the time to subsequent recurrence after a first episode of Acute Pericarditis.

ClinicalTrials.gov [NCT00128453][1].

[1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT00128453&atom=%2Fehj%2F34%2Fsuppl_1%2F877.atom

Risk of Constrictive Pericarditis After Acute Pericarditis

Background—Constrictive Pericarditis (CP) is considered a rare, dreaded possible complication of Acute Pericarditis. Nevertheless, there is a lack of prospective studies that have evaluated the specific risk according to different etiologies. The aim of this study is to evaluate the risk of CP after Acute Pericarditis in a prospective cohort study with long-term follow-up. Methods and Results—From January 2000 to December 2008, 500 consecutive cases with a first episode of Acute Pericarditis (age, 51±16 years; 270 men) were prospectively studied to evaluate the evolution toward CP. Etiologies were viral/idiopathic in 416 cases (83.2%), connective tissue disease/pericardial injury syndromes in 36 cases (7.2%), neoplastic Pericarditis in 25 cases (5.0%), tuberculosis in 20 cases (4.0%), and purulent in 3 cases (0.6%). During a median follow-up of 72 months (range, 24 to 120 months), CP developed in 9 of 500 patients (1.8%): 2 of 416 patients with idiopathic/viral Pericarditis (0.48%) versus 7 of 84 patients…

Colchicine for Acute Pericarditis. Results from the Investigation on Colchicine in Acute Pericarditis (ICAP). A prospective, randomized, double-blind, placebo-controlled, multicenter trial

Purpose: Despite a large amount of data on recurrent Pericarditis, conclusive data are lacking to demonstrate the efficacy and safety of colchicine for the treatment of the first attack of Acute Pericarditis. The Investigation on Colchicine in Acute Pericarditis (ICAP) trial is a prospective, randomized, double-blind, placebo-controlled, multicenter trial aimed at the evaluation of the efficacy and safety of colchicine to treat Acute Pericarditis and prevent its recurrences.

Methods: Eligible adult patients with Acute Pericarditis were randomly assigned to placebo or colchicine (0.5 mg twice daily for 3 months for patients>70kg or 0.5 mg once daily if ≤70kg) in addition to conventional anti-inflammatory therapy with aspirin or ibuprofen in a multicenter, double-blind, placebo-controlled trial. The primary study outcome was incessant/recurrent Pericarditis within 18 months. Secondary outcomes were symptoms persistence at 72 hours, remission within 1 week, number of recurrences, time to first recurrence, disease-related hospitalization, cardiac tamponade, and constrictive Pericarditis.

Results: Of the 240 randomly assigned participants (mean age 52.1±16.9 years, 60% males), 65 patients (27.1%) reached the primary outcome: incessant/recurrent Pericarditis within 18 months was 16.7% in the colchicine group and 37.5% in the placebo group (relative risk reduction 0.56 95% CI 0.30-0.72; number needed to treat-NNT 4). Colchicine reduced symptoms persistence at 72 hours (respectively, 19.2% vs. 40.0%; p=0.001), number of recurrences, hospitalizations (respectively, 5.0% vs. 14.2%; p=0.016), improved the remission rate at 1 week (respectively, 85.0% vs. 58.3%; p

colchicine for Acute Pericarditis results from the investigation on colchicine in Acute Pericarditis icap a prospective randomized double blind placebo controlled multicenter trial

Purpose: Despite a large amount of data on recurrent Pericarditis, conclusive data are lacking to demonstrate the efficacy and safety of colchicine for the treatment of the first attack of Acute Pericarditis. The Investigation on Colchicine in Acute Pericarditis (ICAP) trial is a prospective, randomized, double-blind, placebo-controlled, multicenter trial aimed at the evaluation of the efficacy and safety of colchicine to treat Acute Pericarditis and prevent its recurrences.

Methods: Eligible adult patients with Acute Pericarditis were randomly assigned to placebo or colchicine (0.5 mg twice daily for 3 months for patients>70kg or 0.5 mg once daily if ≤70kg) in addition to conventional anti-inflammatory therapy with aspirin or ibuprofen in a multicenter, double-blind, placebo-controlled trial. The primary study outcome was incessant/recurrent Pericarditis within 18 months. Secondary outcomes were symptoms persistence at 72 hours, remission within 1 week, number of recurrences, time to first recurrence, disease-related hospitalization, cardiac tamponade, and constrictive Pericarditis.

Results: Of the 240 randomly assigned participants (mean age 52.1±16.9 years, 60% males), 65 patients (27.1%) reached the primary outcome: incessant/recurrent Pericarditis within 18 months was 16.7% in the colchicine group and 37.5% in the placebo group (relative risk reduction 0.56 95% CI 0.30-0.72; number needed to treat-NNT 4). Colchicine reduced symptoms persistence at 72 hours (respectively, 19.2% vs. 40.0%; p=0.001), number of recurrences, hospitalizations (respectively, 5.0% vs. 14.2%; p=0.016), improved the remission rate at 1 week (respectively, 85.0% vs. 58.3%; p<0.001), and prolonged time to first recurrence. Corticosteroid use (OR 4.17, 95% CI 1.28 to 13.53; p=0.018), and C-reactive protein elevation at presentation (OR 3.15, 95% CI 1.05 to 9.49; p=0.041) were independent risk factors for recurrences in multivariable analysis. Overall adverse effect rates were similar in the study groups (respectively, 11.7% in the colchicine group and 10.0% in the placebo group; p=0.836) as well as withdrawal rates (respectively, 11.7% vs. 8.3%; p=0.519). No serious adverse effects were observed. Conclusions: The ICAP trial is the first multicenter, double-blind, randomized trial to show the efficacy and safety of colchicine as an adjunct to conventional anti-inflammatory therapy to halve incessant/recurrent Pericarditis within 18 months, reduce the number of recurrences, and prolong the time to subsequent recurrence after a first episode of Acute Pericarditis.

ClinicalTrials.gov [NCT00128453][1].

[1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT00128453&atom=%2Fehj%2F34%2Fsuppl_1%2F877.atom

Risk of Constrictive Pericarditis After Acute Pericarditis

Background—Constrictive Pericarditis (CP) is considered a rare, dreaded possible complication of Acute Pericarditis. Nevertheless, there is a lack of prospective studies that have evaluated the specific risk according to different etiologies. The aim of this study is to evaluate the risk of CP after Acute Pericarditis in a prospective cohort study with long-term follow-up. Methods and Results—From January 2000 to December 2008, 500 consecutive cases with a first episode of Acute Pericarditis (age, 51±16 years; 270 men) were prospectively studied to evaluate the evolution toward CP. Etiologies were viral/idiopathic in 416 cases (83.2%), connective tissue disease/pericardial injury syndromes in 36 cases (7.2%), neoplastic Pericarditis in 25 cases (5.0%), tuberculosis in 20 cases (4.0%), and purulent in 3 cases (0.6%). During a median follow-up of 72 months (range, 24 to 120 months), CP developed in 9 of 500 patients (1.8%): 2 of 416 patients with idiopathic/viral Pericarditis (0.48%) versus 7 of 84 patients…