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이하연Hayeon Lee
경희대학교
J. Am. Coll. Cardiol., Aug 21 2026, S0735-1097(26)07323-7 | https://doi.org/10.1016/j.jacc.2026.07.039
Global, Regional, and National Burden of Myocarditis and Its Impairment, 1990-2023
GBD 2023 Myocarditis Collaborators
Sooji Lee 1∗, Hayeon Lee 2∗, Min Seo Kim 3,4∗, Elaheh Malakan Rad 5, Catherine O. Johnson 6, Laura Lara-Castor 6,7, Hasan Aalruz 8, Yohannes Habtegiorgis Abate 9, Nasir Abbas 10, Hedayat Abbastabar 11, Deldar Morad Abdulah 12, Olugbenga Olusola Abiodun 13, Richard Gyan Aboagye 14,15, Eman Abu-Gharbieh 16,17, Salahdein Aburuz 18,19, Juliana Bunmi Adetunji 20, Prince Owusu Adoma 21, Leticia Akua Adzigbli 22, Danish Ahmad 23,24, Firdos Ahmad 25, Ayman Ahmed 26,27, Haroon Ahmed 28, Sindew Mahmud Ahmed 29,30, Syed Anees Ahmed 31, Salah Al Awaidy 32,33,...Michael Zastrozhin 386,387, Zhiqiang Zhang 388, Jiayan Zhou 389, Magdalena Zielińska 390, Jae Il Shin 391†, Dong Keon Yon 392†, Leslie Trumbull Cooper 393‡, Gregory A. Roth 6,7,300‡
1Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
2Medical Science Research Institute, Kyung Hee University, Seoul, South Korea
3Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA, USA
4Massachusetts General Hospital, Boston, MA, USA
5Department of Pediatric Cardiology, Tehran University of Medical Sciences, Tehran, Iran
...
390Department of Biochemistry and Pharmacogenomics, Medical University of Warsaw, Warsaw, Poland
391Department of Pediatrics, Yonsei University, Seoul, South Korea
392Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University, Seoul, South Korea
393Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, USA
∗These authors equally contributed (as first authors): Sooji Lee, Hayeon Lee, and Min Seo Kim.
†These authors equally contributed (as corresponding authors): Jae Il Shin and Dong Keon Yon.
‡Senior authors: Leslie T. Cooper, Jr and Gregory A Roth.
Address for Correspondence: Dr Dong Keon Yon
Sooji Lee 1∗, Hayeon Lee 2∗, Min Seo Kim 3,4∗, Elaheh Malakan Rad 5, Catherine O. Johnson 6, Laura Lara-Castor 6,7, Hasan Aalruz 8, Yohannes Habtegiorgis Abate 9, Nasir Abbas 10, Hedayat Abbastabar 11, Deldar Morad Abdulah 12, Olugbenga Olusola Abiodun 13, Richard Gyan Aboagye 14,15, Eman Abu-Gharbieh 16,17, Salahdein Aburuz 18,19, Juliana Bunmi Adetunji 20, Prince Owusu Adoma 21, Leticia Akua Adzigbli 22, Danish Ahmad 23,24, Firdos Ahmad 25, Ayman Ahmed 26,27, Haroon Ahmed 28, Sindew Mahmud Ahmed 29,30, Syed Anees Ahmed 31, Salah Al Awaidy 32,33,...Michael Zastrozhin 386,387, Zhiqiang Zhang 388, Jiayan Zhou 389, Magdalena Zielińska 390, Jae Il Shin 391†, Dong Keon Yon 392†, Leslie Trumbull Cooper 393‡, Gregory A. Roth 6,7,300‡
1Department of Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
2Medical Science Research Institute, Kyung Hee University, Seoul, South Korea
3Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA, USA
4Massachusetts General Hospital, Boston, MA, USA
5Department of Pediatric Cardiology, Tehran University of Medical Sciences, Tehran, Iran
...
390Department of Biochemistry and Pharmacogenomics, Medical University of Warsaw, Warsaw, Poland
391Department of Pediatrics, Yonsei University, Seoul, South Korea
392Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University, Seoul, South Korea
393Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, FL, USA
∗These authors equally contributed (as first authors): Sooji Lee, Hayeon Lee, and Min Seo Kim.
†These authors equally contributed (as corresponding authors): Jae Il Shin and Dong Keon Yon.
‡Senior authors: Leslie T. Cooper, Jr and Gregory A Roth.
Address for Correspondence: Dr Dong Keon Yon
Abstract
Background: The impact of recent trends in the burden of myocarditis has not been reported in detail.
Objectives: This study aims to estimate the global, regional, and national burden of myocarditis from 1990 to 2023, using data from the GBD (Global Burden of Disease, Injuries, and Risk Factors Study) 2023.
Methods: As part of the GBD 2023, the authors used all available administrative health facility and vital registration data to estimate myocarditis prevalence, incidence, disability-adjusted life years (DALYs), mortality, and mortality-to-incidence ratio (MIR) for every country, stratified by age, sex, and quintiles of a Socio-demographic Index (SDI). The MIR represents the relative mortality burden compared with disease incidence at the population level. The prevalence of heart failure attributable to myocarditis was estimated using a model-based attribution approach.
Results: In 2023, the global age-standardized rates of prevalence, incidence, DALY, and mortality of myocarditis were 4.84 (95% uncertainty interval [UI]: 3.98-5.80), 12.46 (95% UI: 9.86-15.70), 8.41 (95% UI: 5.63-12.59) and 0.21 (95% UI: 0.14-0.29) per 100,000 population, respectively. Although global age-standardized prevalence and incidence rates remained stable from 1990 to 2023, the absolute number of incident cases increased by 54.28% from 0.67 million (95% UI: 0.52-0.85 million) to 1.04 million (95% UI: 0.83-1.32 million). Age-standardized DALYs and mortality rates decreased by 62.48% and 60.00%, respectively, over the same period. The MIR decreased across all age groups from 1990 to 2023 and remained highest among the youngest and oldest populations, with the ratio in those <5 years of age declining from 17.82% in 1990 to 6.32% in 2023. Across SDI strata, incidence rates remained stable from 1990 to 2023, while mortality rates declined in all quintiles and remained lowest in high SDI regions, whereas the MIR decreased from 2.33 in 1990 to 1.30 in 2023. In 2023, prevalence was highest in the high SDI quintile (6.30 [95% UI: 5.15-7.48] per 100,000 population) and lowest in the low-middle SDI quintile (4.10 [95% UI: 3.38-5.02]), reflecting disparities aligned with health resource availability. Age-standardized prevalence rates of heart failure attributable to myocarditis declined from 2.33 (95% UI: 1.90-2.90) per 100,000 population in 1990 to 1.76 (95% UI: 1.41-2.29) in 2023, with a U-shaped distribution across age groups showing the highest burden in those <5 years of age and >75 years of age in 2023.
Conclusions: Although age-adjusted DALYs and mortality rates of myocarditis decreased globally from 1990 to 2023, incidence and prevalence remained stable, suggesting potential improvements in outcomes over time. However, absolute burden has grown due to population growth and aging, and important disparities persist across age groups and SDI strata. These findings highlight the need for targeted strategies to improve early diagnosis and reduce the burden of myocarditis, particularly in vulnerable populations and lower-resource settings, while being interpreted in the context of evolving diagnostic and coding practices.
Objectives: This study aims to estimate the global, regional, and national burden of myocarditis from 1990 to 2023, using data from the GBD (Global Burden of Disease, Injuries, and Risk Factors Study) 2023.
Methods: As part of the GBD 2023, the authors used all available administrative health facility and vital registration data to estimate myocarditis prevalence, incidence, disability-adjusted life years (DALYs), mortality, and mortality-to-incidence ratio (MIR) for every country, stratified by age, sex, and quintiles of a Socio-demographic Index (SDI). The MIR represents the relative mortality burden compared with disease incidence at the population level. The prevalence of heart failure attributable to myocarditis was estimated using a model-based attribution approach.
Results: In 2023, the global age-standardized rates of prevalence, incidence, DALY, and mortality of myocarditis were 4.84 (95% uncertainty interval [UI]: 3.98-5.80), 12.46 (95% UI: 9.86-15.70), 8.41 (95% UI: 5.63-12.59) and 0.21 (95% UI: 0.14-0.29) per 100,000 population, respectively. Although global age-standardized prevalence and incidence rates remained stable from 1990 to 2023, the absolute number of incident cases increased by 54.28% from 0.67 million (95% UI: 0.52-0.85 million) to 1.04 million (95% UI: 0.83-1.32 million). Age-standardized DALYs and mortality rates decreased by 62.48% and 60.00%, respectively, over the same period. The MIR decreased across all age groups from 1990 to 2023 and remained highest among the youngest and oldest populations, with the ratio in those <5 years of age declining from 17.82% in 1990 to 6.32% in 2023. Across SDI strata, incidence rates remained stable from 1990 to 2023, while mortality rates declined in all quintiles and remained lowest in high SDI regions, whereas the MIR decreased from 2.33 in 1990 to 1.30 in 2023. In 2023, prevalence was highest in the high SDI quintile (6.30 [95% UI: 5.15-7.48] per 100,000 population) and lowest in the low-middle SDI quintile (4.10 [95% UI: 3.38-5.02]), reflecting disparities aligned with health resource availability. Age-standardized prevalence rates of heart failure attributable to myocarditis declined from 2.33 (95% UI: 1.90-2.90) per 100,000 population in 1990 to 1.76 (95% UI: 1.41-2.29) in 2023, with a U-shaped distribution across age groups showing the highest burden in those <5 years of age and >75 years of age in 2023.
Conclusions: Although age-adjusted DALYs and mortality rates of myocarditis decreased globally from 1990 to 2023, incidence and prevalence remained stable, suggesting potential improvements in outcomes over time. However, absolute burden has grown due to population growth and aging, and important disparities persist across age groups and SDI strata. These findings highlight the need for targeted strategies to improve early diagnosis and reduce the burden of myocarditis, particularly in vulnerable populations and lower-resource settings, while being interpreted in the context of evolving diagnostic and coding practices.
논문정보
- Research article
- 2026년 08월 (BRIC 등록일 2026-09-03)
- 국내(교신)+국외 연구진
- 의약학 > 의약학 기타
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