Cardiac involvement occurred in 20.5% of hypereosinophilia patients and was associated with a higher 3-year mortality rate (17.7% vs 7.9%, P=0.18).
Does cardiac involvement increase the risk of all-cause death in patients with hypereosinophilia?
Cardiac involvement is present in approximately 20% of patients with hypereosinophilia and is associated with a numerically higher, though not statistically significant, rate of all-cause mortality.
Absolute Event Rate: 0% vs 0%
Abstract Background Hypereosinophilia can lead to myocardial injury, represented by Löffler's endocarditis. However, reports on their frequency and prognosis are scarce. This study aimed to assess the frequency of cardiac involvement and the prognosis of patients with hypereosinophilia. Methods We searched our hospital records from 2011 to 2024 for patients diagnosed with hypereosinophilia. We defined hypereosinophilia as follows: patients with a registered diagnosis of hypereosinophilia on an electronic hospital chart or patients with absolute eosinophil count exceeding 1500 cells/µl consecutively and clinician mentions hypereosinophilia in the medical record. We excluded patients with leukemia other than eosinophilic leukemia. The patients with hypereosinophilia were classified according to the etiology: idiopathic hypereosinophilic syndrome (HES), reactive hyper-eosinophilia including patients with eosinophilic granulomatosis with polyangiitis, and primary hypereosinophilia. Cardiac involvement was defined as clinically evident myocardial damage detected by elevated high-sensitive troponin levels, consistent findings by transthoracic echocardiography or magnetic resonance imaging. The primary outcome measure was all-cause death. Results We identified 132 patients with hypereosinophilia: 42 cases (31.8%) of idiopathic HES, 88 patients (66.7%) of reactive hypereosinophilia including 10 cases (7.6%) with eosinophilic granulomatosis with polyangiitis, and two primary hypereosinophilia (0.02%). Among patients with available data, elevated troponin levels were found in 22.0%, and ECG changes indicative of myocardial injury were present in 18.1%. Cardiac involvement was observed in 27 patients (20.5%), and 14 patients were diagnosed with Löffler's endocarditis. Nine patients (6.8%) had a stroke at the diagnosis of hypereosinophilia. During a median follow-up of 1,031 days, thromboembolic events occurred in twelve patients, and eighteen patients died. The incidence of all-cause death was numerically higher in the patients with cardiac involvement, relative to those without at the 3-year follow-up (17.7% versus 7.9%, P=0.18). Conclusions Cardiac involvement was present in about one-fifth of the patients with hypereosinophilia and was suggestive of increased mortality. Early recognition of cardiac involvement may be useful for stratifying the outcomes of patients with hypereosinophilia.
Miyazaki et al. (Sat,) reported a other. Cardiac involvement occurred in 20.5% of hypereosinophilia patients and was associated with a higher 3-year mortality rate (17.7% vs 7.9%, P=0.18).
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