# Incidence, prevalence, and global burden of myocarditis among individuals aged 65 and older from 1990 to 2021 across 204 countries: a critical re-analysis of data from the global burden of disease study

## TL;DR

This study analyzes the global rise in myocarditis among people aged 65 and older from 1990 to 2021, highlighting the growing health crisis and the role of low temperature as a key risk factor.

## Contribution

The study provides a critical re-analysis of global myocarditis burden data and projects future trends using advanced statistical and modeling techniques.

## Key findings

- A significant increase in myocarditis burden was observed in the elderly population after 2010.
- Low temperature was identified as a primary risk factor for myocarditis-related mortality.
- The study projects a continued rise in disease burden among aging populations globally.

## Abstract

Myocarditis is an inflammatory disease of the heart muscle that can lead to significant morbidity and mortality, particularly in the elderly population (≥65 years). This study aimed to provide a comprehensive global, regional, and national burden analysis of myocarditis from 1990 to 2021, with a prediction for 2050. We employed a variety of methodologies, including the estimation of age-standardized incidence rates, prevalence, disability-adjusted life years (DALYs), and their estimated annual percentage change (EAPC). Additionally, we analyzed age, sex, and temporal trends using line graphs and trend charts, revealing the shifts in disease burden across different demographics. Joinpoint regression analysis was performed to identify significant changes in burden over time, while the relationship between disease burden and the Socio-Demographic Index (SDI) was explored through a curve plot with a dot plot overlay. Age-period-cohort analysis was conducted to assess the influences of age effects, period effects, and cohort effects on disease burden. Decomposition analysis was employed to understand the impacts of population growth, aging, and epidemiological changes on the overall burden. Furthermore, we identified key risk factors contributing to myocarditis burden through curves and attributable risk ratios. Finally, Bayesian Age-Period-Cohort (BAPC) modeling was utilized to project the disease burden of myocarditis globally until 2050. Evidence suggests that a pivotal shift in disease burden occurred after 2010, with low temperature emerging as a primary risk factor for mortality. Our findings indicate a concerning trend in the increasing burden of myocarditis among the aging population, underscoring the urgent need for targeted public health strategies and further research to mitigate this growing health crisis.