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American Journal of Epidemiology Advance Access originally published online on January 19, 2007
American Journal of Epidemiology 2007 165(5):570-574; doi:10.1093/aje/kwk076
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American Journal of Epidemiology Copyright © 2007 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.

ORIGINAL CONTRIBUTIONS

Incidence of Fatal Myocarditis: A Population-based Study in Finland

Ville Kytö1,2, Antti Saraste2, Liisa-Maria Voipio-Pulkki3 and Pekka Saukko4

1 Department of Anatomy, University of Turku, Turku, Finland
2 Department of Medicine, University of Turku, Turku, Finland
3 Department of Medicine, University of Helsinki, Helsinki, Finland
4 Department of Forensic Medicine, University of Turku, Turku, Finland

Correspondence to Ville Kytö, Department of Anatomy, University of Turku, Kiinamyllynkatu 10, 20520 Turku, Finland (e-mail: ville.kyto{at}utu.fi).

Received for publication December 23, 2005. Accepted for publication September 25, 2006.

To study the incidence of fatal myocarditis in the general population, the authors retrospectively collected all death certificates recording myocarditis as the underlying cause of death in Finland in 1970–1998. The incidence of myocarditis and its proportion of all deaths were calculated from 141.4 million person-years and 1.35 million deaths. Myocarditis was recorded as the underlying cause of death in 639 cases. Thus, its death certificate-based incidence was 0.46 (95% confidence interval (CI): 0.43, 0.49) per 100,000 person-years, and it caused 0.47 (95% CI: 0.44, 0.51) of 1,000 deaths. The incidence of 0.51 (95% CI: 0.46, 0.56) in males was higher than the incidence of 0.42 (95% CI: 0.37, 0.47) in females, the odds ratio being 1.34 (95% CI: 1.15, 1.58) (p < 0.001). The proportion of deaths caused by myocarditis was highest (up to six of 1,000 deaths) in children and adults aged less than 45 years. Because previous histopathologic reanalysis showed that only 32% of cases fulfilled the Dallas criteria, the authors estimated the incidence of histopathologically certain fatal myocarditis to be 0.15 (95% CI: 0.13, 0.17) per 100,000. The death certificate-based incidence of fatal myocarditis was found to be 0.46 per 100,000, and the histopathologically corrected incidence was 0.15 per 100,000.

fatal outcome; incidence; myocarditis


Abbreviations: CI, confidence interval


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