Accepted for/Published in: JMIR Public Health and Surveillance
Date Submitted: Feb 22, 2023
Open Peer Review Period: Feb 20, 2023 - Mar 15, 2023
Date Accepted: Dec 10, 2023
(closed for review but you can still tweet)
Global, Regional, and National Burden of Myocarditis in 204 Countries and Territories, 1990–2019: Updated Systematic Analysis
ABSTRACT
Background:
Myocarditis characterized by high disability and mortality imposes severe burdens on population health globally. But the latest global magnitude and secular trend of myocarditis burden has not been reported.
Objective:
The study aimed to delineate the epidemiological characteristics globally in myocarditis burden for optimizing targeted prevention and research.
Methods:
Based on the Global Burden of Disease Study 2019, the myocarditis burden from 1990 to 2019 was modeled by the Cause of Death Ensemble tool, DisMod-MR, and spatiotemporal Gaussian regression. We depicted the epidemiology and trends of myocarditis by sex, age, year, region, and socio-demographic index (SDI). R program version 4.2.1 was applied for all statistical analyses, and the two-sided P-value <0.05 was assumed statistically significant.
Results:
The number of incident cases (1 268 000) and deaths (32 450) of myocarditis in 2019 increased by above 1.6 times compared with 1990 globally; the age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) decreased slightly from 1990 to 2019. The age-standardized disability-adjusted life years (DALYs) decreased slightly in the past three decades; while the DALY rate (ASDR) decreased obviously from 18.29 in 1990 to 12.81 per 100 000 person-years in 2019. The higher SDI regions always showed more significant ASIR. The ASIR slightly decreased in all SDI regions between 1990 and 2019. The Middle SDI region presented the highest ASMR and ASDR in 2019. The LOW SDI region showed the lowest ASMR and ASDR in 2019. The ASRs of myocarditis among males were higher than that among females from 1990 to 2019 globally. All ASRs among both sexes were on a downward trend except for the stable trend of ASMR among males, and females had a more significant decrease in ASDR than males. Senior citizens had a larger quantity of incident cases and deaths among both sexes in 2019. The peak numbers of DALYs for both sexes presented in the age group under 1 year old in 2019. At the national level, the EAPCs of ASRs had significant negative correlations with the baseline ASRs in 1990.
Conclusions:
Globally, the number of incident cases and deaths of myocarditis increased significantly; conversely, ASRs of myocarditis presented decreasing trends from 1990 to 2019. The males consistently showed higher ASRs of myocarditis than females from 1990 to 2019 globally. Senior citizens gradually predominated in myocarditis burden. Policymakers should establish targeted control based on gender, region, age, and SDI; strengthen aging-related health research; and take notice of the changes in epidemic characteristics of myocarditis.
Citation
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Copyright
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