Fulminant myocarditis: outcome predictors in an international cohort study.

Older age, lower initial pH, and giant-cell myocarditis on endomyocardial biopsy are independently linked to higher in-hospital and 1-year mortality in adults with fulminant myocarditis.

• Why it matters: Long-term prognosis and reliable mortality risk factors in fulminant myocarditis are still insufficient, limiting identification of high-risk patients and selection of targeted treatment strategies.
• What they did: In a retrospective cohort of 271 consecutive adults admitted for fulminant myocarditis across 26 European tertiary centers (Jan 2012–Nov 2022), investigators used multivariable logistic regression to relate prespecified factors and EMB-based histopathology to in-hospital and 1-year mortality.
• The result: Overall in-hospital and 1-year mortality were 31% and 34%, with the highest 1-year mortality in giant-cell myocarditis (54%); survivors to discharge showed excellent functional outcomes and ventricular recovery.

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