Myocarditis in Patients With Idiopathic Inflammatory Myopathies: Clinical Presentation and Outcomes

作者：Melody P. Chung, Jana Lovell, William G. Kelly, Christopher A. Mecoli, Jemima Albayda, Lisa Christopher‐Stine, Nisha A. Gilotra, Julie J. Paik · 发表于：The Journal of Rheumatology · 年份：2023 · DOI：10.3899/jrheum.220989 · 被引用次数：17 · 研究领域：Inflammatory Myopathies and Dermatomyositis、Viral Infections and Immunology Research、Eosinophilic Disorders and Syndromes

OBJECTIVE: To determine the clinical phenotype and outcomes of patients with idiopathic inflammatory myopathies (IIMs) and myocarditis. METHODS: Using the Johns Hopkins Myositis Center Research Registry, we identified 31 adult patients with IIM-out of a total of 3082 with confirmed or suspected muscle disease-with an encounter code of myocarditis from 2004 to 2021. Of these, 14 adult patients with IIM were adjudicated to have clinical myocarditis. Information about demographics, autoantibodies, and clinical outcomes was retrospectively collected and analyzed. RESULTS: Of 14 patients with IIM with clinical myocarditis, the median age at IIM diagnosis was 49 (IQR 35-56) years, and the median age at myocarditis diagnosis was 54 (IQR 36-61) years. The median duration between IIM diagnosis and myocarditis was 3 (IQR 2-9) years. The majority of patients were female (8/14, 57%) and Black (10/14, 71%). Antisynthetase syndrome was the most common IIM subtype (9/14, 64%). Anti-Jo1 (n = 4) and anti-PL12 (n = 3) were the most frequent autoantibodies. At myocarditis diagnosis, most patients (11/14, 79%) had active myositis, defined as elevated creatine kinase and/or muscle weakness; required hospitalization (13/14, 93%); and had reduced left ventricular ejection fraction (LVEF < 50%; 10/14, 71%). Despite intensification of immunosuppression, the 5-year overall survival rate from IIM diagnosis was 84%, and the 5-year overall survival rate from myocarditis diagnosis was 53%. Systolic dysfun...