Kindermann et al identified factors associated with a poor outcome in patients with suspected viral myocarditis. These can help to identify a patient who may benefit from more aggressive management. The authors are from Universitatsklinikum des Saarlandes, Universitatsklinikum Tubingen, Klinik fur Innere Medizine III and Klinik fur Padiatrische Kardiologie in Germany.
Patient selection: suspected viral myocarditis
Outcome: all cause death or heart transplant
Predictors for outcome:
(1) New York Heart Association Class III or IV at presentation (hazard ratio 3.2)
(2) positive immunohistochemical stains for an inflammatory infiltrate (hazard ratio 3.5)
(3) failure to treat with a beta-blocker (hazard ratio (hazard ratio 2.3)
The risk of a poor income increases with the number of predictors present.
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