Global, regional and national epidemiology of myocarditis: health inequalities, risk factors and forecasted burden based on the Global Burden of Disease Study 2021.

Abstract

Background: Myocarditis is a global epidemic that causes various medical conditions associated with an increased incidence and death numbers. This study aimed to investigate the trends in myocarditis-associated incidence, mortality, and disability-adjusted life-years (DALYs) with health inequalities, risk factors, and predict the disease burden, thereby mitigating the health hazards of myocarditis.

Methods: This was a modelling study that used data from the Global Burden of Diseases 2021, from which myocarditis was included in the analysis. Incidence, death, DALYs, age-standardised incidence rate (ASIR), age-standardised mortality rate (ASMR), age-standardised DALYs rate (ASDR), cases change, corresponding estimated annual percentage change (EAPC), Slope Inequality of Index (SII) and Concentration Index were analysed.

Results: From 1990 to 2021, incidence and death cases increased by 66.88% and 45.94%, respectively. The myocarditis-associated incidence and death cases increased in all five sociodemographic index (SDI) regions. Among the five SDI regions, the High SDI region had the highest myocarditis-associated ASIR with the least ASMR and ASDR in 2021. Regionally, Central Asia had the largest increase in EAPC of ASIR, ASMR and ASDR. Among 204 countries, Japan had the highest ASIR in 2021 and Romania had the highest ASMR and ASDR. Between 1990 and 2021, the SII and Concentration Index for DALYs have shown declining trends. The extreme temperatures were major contributors to the burden of myocarditis during 1990-2021. The projections suggested that the myocarditis-related global number of new cases and death would increase over the next 15 years. There may be upward trends in people of 15+of incidence number and 40+of death and DALYs number.

Conclusions: Myocarditis is an increasing global health challenge with rising incidence and death. Management of extreme temperatures remains a major challenge. The number of incidence, death and DALYs in different age groups would continue to grow over the next 15 years. Therefore, measures should be taken to target risk factors and high-risk groups.