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Recurrent Myocarditis in Young Adults: Identifying High-Risk Phenotypes and the Protective Effect of Adequate Colchicine Therapy.

Recurrent Myocarditis in Young Adults: Identifying High-Risk Phenotypes and the Protective Effect of Adequate Colchicine Therapy.

期刊: Medicina (Kaunas, Lithuania) 日期: 2026-07-09 PMID: 42512865 DOI: 10.3390/medicina62071323 浏览: 26
作者: Senturk B, Colluoglu T, Oktay C, Turk AUF, Balikoglu I, Yavuz M, Kis M, Dursun H, Yilmaz MB
B, S., T, C., C, O., AUF, T., I, B., M, Y., M, K., H, D., & MB, Y. (2026). Recurrent Myocarditis in Young Adults: Identifying High-Risk Phenotypes and the Protective Effect of Adequate Colchicine Therapy.. Medicina (Kaunas, Lithuania). https://doi.org/10.3390/medicina62071323
B S, T C, C O, AUF T, I B, M Y, et al. Recurrent Myocarditis in Young Adults: Identifying High-Risk Phenotypes and the Protective Effect of Adequate Colchicine Therapy.. Medicina (Kaunas, Lithuania). 2026; doi: 10.3390/medicina62071323
B S, T C, C O, et al. Recurrent Myocarditis in Young Adults: Identifying High-Risk Phenotypes and the Protective Effect of Adequate Colchicine Therapy.[J]. Medicina (Kaunas, Lithuania). 2026. DOI: 10.3390/medicina62071323.
@article{b2026,
  author = {Senturk B and Colluoglu T and Oktay C and Turk AUF and Balikoglu I and Yavuz M and Kis M and Dursun H and Yilmaz MB},
  title = {Recurrent Myocarditis in Young Adults: Identifying High-Risk Phenotypes and the Protective Effect of Adequate Colchicine Therapy.},
  journal = {Medicina (Kaunas, Lithuania)},
  year = {2026},
  doi = {10.3390/medicina62071323},
  note = {PMID: 42512865},
}
TY  - JOUR
AU  - Senturk B
AU  - Colluoglu T
AU  - Oktay C
AU  - Turk AUF
AU  - Balikoglu I
AU  - Yavuz M
AU  - Kis M
AU  - Dursun H
AU  - Yilmaz MB
TI  - Recurrent Myocarditis in Young Adults: Identifying High-Risk Phenotypes and the Protective Effect of Adequate Colchicine Therapy.
T2  - Medicina (Kaunas, Lithuania)
PY  - 2026
DO  - 10.3390/medicina62071323
AN  - PMID:42512865
ER  - 

摘要

Background and Objectives: Recurrent myocarditis confers a significant prognostic burden yet lacks validated predictive markers to guide risk stratification. This study aimed to identify independent clinical, electrocardiographic, and cardiac magnetic resonance (CMR) determinants of recurrence at a median of 7 days (IQR: 3-14) after the index event in young adults with acute myocarditis and to evaluate the role of colchicine therapy duration in modulating recurrence risk. Materials and Methods: This retrospective observational cohort study enrolled 162 patients admitted with a diagnosis of acute myocarditis to a tertiary cardiology center between January 2014 and January 2024. Diagnosis was established according to ICD-10 criteria with confirmation by CMR. The primary endpoint was recurrent myocarditis at two-year follow-up. Independent predictors were delineated through binary logistic regression and time-to-event analyses using multivariate Cox proportional hazards modeling. Results: The two-year recurrence rate was 12.3%, with a median time to recurrence of 13.5 months. Time of colchicine use, ST-segment depression on the admission electrocardiogram (OR 14.469, 95%CI 2.416-86.673; p = 0.003), and late gadolinium enhancement (LGE) on CMR (OR 10.362, 95%CI 1.614-66.549; p = 0.014) emerged as independent predictors of recurrence. Colchicine therapy sustained for a minimum of three months was independently associated with a markedly reduced recurrence risk (OR = 0.295, 95%CI = 0.098-0.891; p = 0.030). Cox regression corroborated these associations, demonstrating substantially elevated hazard ratios for ST depression (HR = 10.729, 95%CI = 2.201-52.298; p = 0.003) and LGE (HR = 8.064, 95%CI = 2.036-31.942; p = 0.003), with a protective effect of adequate colchicine duration (HR = 8.577 for treatment cessation; p = 0.025). A multisegmental LGE pattern and index episode onset during the winter months were additionally associated with recurrence. Conclusions: ST-segment depression on admission electrocardiography and CMR-detected LGE may represent potent, independent predictors of myocarditis recurrence. Adequate colchicine duration of at least three months may attenuate recurrence risk, underscoring the critical importance of optimizing anti-inflammatory therapy duration and integrating electrocardiographic and imaging phenotyping into personalized long-term surveillance strategies.

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