AIM  To analyze the related factors influencing the early prognosis and follow-up results in adult patients with acute fulminant myocarditis.

  METHODS  The study included 52 adult patients with acute fulminant myocarditis and 20 adult patients with acute myocarditis in our hospital from January 2013 to December 2017. Fifty-two patients with acute fulminant myocarditis were divided into two groups according to results of treatment: survivor group (44 cases) and nonsurvivor group (8 cases). Data including clinical symptoms, laboratory examination, therapy method, and acute complication were compared between the two groups. The relationship between the data and the results of treatment was retrospectively analyzed. The related factors leading to death were analyzed by binary logistic regression (forward method). All patients in survivor group (44 cases) and acute myocarditis group (20 cases) were followed up for 0.5-5 years and the re-hospitalization rate and the morbidity of dilated cardiomyopathy (DCM) were compared.

  RESULTS  Compared with those in survival group, the incidence of QRS wave duration, cardiac shock, serum creatinine, troponin I (cTnI) and Brain natriuretic peptide (BNP) level significantly increased in nonsurvivor group. Furthermore, binary logistic regression analysis suggested that serum creatinine, cTnI and BNP level were independently correlated with the prognosis in patients with fulminant myocarditis. No significant difference was found in the re-hospitalization rate and the morbidity of DCM between survival group and nonsurvivor group.

  CONCLUTION  Serum creatinine, cTnI and BNP are independent predictors of poor prognosis. Adult patients with acute fulminant myocarditis discharged from hospital have good long-term prognosis.