Vasculitis & polymyalgia rheumatica
Cardiac involvement in eosinophilic granulomatosis with polyangiitis: acute eosinophilic myocarditis and chronic inflammatory cardiomyopathy
Authors' conclusion
We first proposed different subtypes of cardiac involvement in EGPA. Identification and treatment of EGPA-EM needs improvement. LATE-EAST score could recognize the high-risk EGPA-EM effectively.
Study context
- Population
- Eosinophilic granulomatosis with polyangiitis (EGPA) patients hospitalized in one centre 2012–2023 and in public databases118 with cardiac involvement
- Participants
- 193 patients
- Exposure
- EGPA-EM vs EGPA-ICM vs EGPA-Control
- EGPA-EMn = 74
- EGPA-ICMn = 44
- EGPA-Controln = 75reference
- Outcome
- Clinical and laboratory features across groups
Methodological detailssingle-centre and public database cases
- Single-centre and public database cases
Main finding
As reported in the abstract
- Eosinophils, EGPA-Control/EGPA-ICM/EGPA-EM (× 109/l), P < 0.01
- 6.12/8.71/10.42
- ANCA positivity, EGPA-Control/EGPA-ICM/EGPA-EM, P < 0.01
- 41.33/31.82/14.86%
- Lung involvement, EGPA-Control/EGPA-ICM/EGPA-EM, P = 0.02
- 73.33/72.73/43.24%
- Cardiac troponin (ng/ml), EGPA-ICM vs EGPA-EM, P < 0.01
- 0.27 vs 6.00
- Ejection fraction, EGPA-ICM vs EGPA-EM, P < 0.01
- 57.79 vs 33.20%
- ST-T abnormality, EGPA-EM vs EGPA-ICM, P = 0.02
- 41.89 vs 20.45%
Observational data: associations, not effects.
Further findings
- Prognosis of EGPA-EM
- 14.86%
- LATE-EAST diagnostic score (7 items, 9 points; threshold 4 points) to discriminate EGPA-EM from EGPA-ICM: LATE-EAST score AUC 0.85 (95% CI 0.78-0.92) · sensitivity 0.78 · specificity 0.86
Prognosis of EGPA-EM
- Prognosis of EGPA-EM significantly worse; 2-year event-free survival rate below 50%
Original publication
Cardiac involvement in eosinophilic granulomatosis with polyangiitis: acute eosinophilic myocarditis and chronic inflammatory cardiomyopathy. Rheumatology (Oxford). Published 9 February 2024. doi:10.
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