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cardio.cardiac-tamponade.dressler-syndrome.v1

Cardiac tamponade — Dressler syndrome (post-cardiac-injury syndrome)

cardiologyacuteadult
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Dressler syndrome / PCIS — autoimmune pericarditis 2-12 wk post-cardiac-injury; high-dose ASA + colchicine first-line (preferred post-MI); NSAIDs + colchicine alternative (post-surgery); corticosteroids reserved for refractory; pericardiocentesis only if tamponade (~10-20% of cases) (ESC 2015 §Post-Cardiac Injury Syndrome; Imazio CIRCS NEJM 2015 PMID 26315582)

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PCIS context with appropriate timing post-injury suspected

Patient inputs (11)

Older patients have higher post-MI Dressler risk + worse drug tolerance (Adler 2015 BMJ)

Compensatory tachycardia in tamponade physiology + low-grade tachycardia from inflammation (Imazio ICAP PMID 23992557)

MI vs CABG vs valve surgery vs lead implant vs ablation vs trauma; days-weeks elapsed since injury — drives diagnosis confidence + therapy selection (ASA preferred post-MI vs NSAID acceptable post-surgery) (ESC 2015; Imazio CIRCS PMID 26315582)

DAPT / DOAC / warfarin status drives hemorrhagic component risk + NSAID safety + pericardiocentesis bleeding risk (ESC 2015)

Low-grade fever (typically 37.5-38.5°C) is a hallmark — present in ~70-80% of cases (Adler 2015 BMJ)

Definitive bedside dx — chamber collapse, IVC, swinging heart if tamponade; effusion size + character drives drainage decision (ESC 2015 Class I)

CRP elevation is a key diagnostic criterion + treatment response marker; trend to <1 mg/dL guides therapy de-escalation (Imazio ICAP PMID 23992557)

Leukocytosis present in ~60-70% of cases; supports diagnosis when other criteria present (Adler 2015 BMJ)

Baseline for NSAID + colchicine renal dose adjustment (CrCl <30 → avoid colchicine) + ASA renal safety (ESC 2015)

Often mildly elevated from associated myopericarditis component; helps differentiate from re-infarction (Adler 2015 BMJ)

Hypotension is part of Beck triad if tamponade physiology develops (~10-20% of cases) (ESC 2015)

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Severity triggers (5)

5 need judgement
  • informationallife_threateningtamponade_physiology_in_pcis_requiring_emergent_drainage
    Beck triad + echo evidence of tamponade physiology in PCIS patient — ~10-20% of PCIS cases develop tamponade requiring emergent pericardiocentesis (ESC 2015 Class I; Imazio JAMA 2014 PMID 25268438)
    Trigger could not be auto-evaluated — needs clinician judgement.
  • informationallife_threateninghemorrhagic_pcis_in_post_pci_patient_on_dapt_or_anticoagulation
    PCIS patient on DAPT or anticoagulation with hemorrhagic effusion + tamponade — emergent reversal + drainage required (ESC 2015; Bhatt Circulation 2018)
    Trigger could not be auto-evaluated — needs clinician judgement.
  • informationalseveredifferential_re_infarction_vs_dressler_in_post_mi_chest_pain
    Post-MI patient (2-12 wk post-event) presenting with chest pain — must differentiate Dressler vs re-infarction (ESC 2015; ACC/AHA STEMI 2025)
    Trigger could not be auto-evaluated — needs clinician judgement.
  • informationalsevererefractory_pcis_despite_first_line_therapy
    PCIS not responding to ASA / NSAID + colchicine after 1-2 weeks — escalation to corticosteroids required per ESC 2015 (LOW dose only)
    Trigger could not be auto-evaluated — needs clinician judgement.
  • informationalseveremultiple_recurrent_pericarditis_with_steroid_dependence
    Multiple recurrences (≥2 episodes after symptom-free intervals) with steroid dependence — escalation to biologic therapy (anakinra) per AIRTRIP trial (Brucato JAMA 2016)
    Trigger could not be auto-evaluated — needs clinician judgement.

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Recommended regimen

Dressler / PCIS — high-dose ASA + colchicine first-line (preferred post-MI); NSAID + colchicine alternative (post-surgery); corticosteroids reserved for refractory (ESC 2015 §PCIS; Imazio CORP-2 Lancet 2014 PMID 24239018; Imazio ICAP NEJM 2013 PMID 23992557)
axis: pcis_dressler_high_dose_asa_or_nsaid_plus_colchicine_first_line
Selected axis "Dressler / PCIS — high-dose ASA + colchicine first-line (preferred post-MI); NSAID + colchicine alternative (post-surgery); corticosteroids reserved for refractory (ESC 2015 §PCIS; Imazio CORP-2 Lancet 2014 PMID 24239018; Imazio ICAP NEJM 2013 PMID 23992557)" by default fallback (first axis)
  • aspirin
    first line
    salicylate_anti_inflammatory
    750-1000 mg PO TID × 1-2 wk then taper by 250-500 mg q1-2 wk per CRP normalization (total ~6-8 wk) • PO • TID with food + PPI prophylaxis
    triggers: post_mi_pcis_preferred_for_antiplatelet_benefit, first_line_anti_inflammatory
    ESC 2015 §PCIS — preferred post-MI given continued antiplatelet benefit; high-dose anti-inflammatory effect; PPI prophylaxis essential for GI protection
    rxcui 1191
  • ibuprofen
    first line
    nsaid
    600 mg PO TID × 1-2 wk then taper to 400 mg TID × 1 wk then 400 mg BID × 1 wk • PO • TID with food + PPI prophylaxis
    triggers: post_surgery_pcis_or_distant_from_mi, asa_intolerance
    Imazio ICAP PMID 23992557 — alternative first-line if post-surgery or non-MI context; equivalent efficacy to ASA
    rxcui 5640
  • indomethacin
    second line
    nsaid
    25-50 mg PO TID × 1-2 wk then taper • PO • TID with food + PPI prophylaxis
    triggers: ibuprofen_intolerance_or_inadequate_response
    Alternative NSAID — historically used in PCIS; AVOID in elderly + CHF + CKD due to CV / renal risks (ESC 2015)
    rxcui 5781
  • colchicine
    first line
    microtubule_inhibitor_anti_inflammatory
    0.5 mg PO BID × 3 mo (0.5 mg daily if weight <70 kg or CrCl 30-60) • PO • BID × 3 mo
    triggers: always_combine_with_asa_or_nsaid_for_pcis
    CORP-2 PMID 24239018 + ICAP PMID 23992557 + COPPS-2 PMID 25268438 — RR 0.56 reduction in recurrence; cornerstone of modern PCIS management; ALWAYS combined with first-line anti-inflammatory
    rxcui 2683
  • prednisolone
    second line
    corticosteroid
    0.2-0.5 mg/kg/d × 2-4 wk then SLOW taper over 6-8 wk (decrease by 5-10 mg/wk to 25 mg, then 2.5 mg/wk to 15 mg, then 1-2.5 mg q2wk to discontinuation) • PO • daily with slow taper
    triggers: refractory_to_asa_nsaid_plus_colchicine, contraindication_to_first_line, pregnancy_third_trimester_nsaid_contraindicated
    ESC 2015 — RESERVED for refractory cases or contraindications; LOW-DOSE preferred (0.2-0.5 mg/kg/d) — high-dose steroids INCREASE recurrence risk per CORP-2 + ICAP; very slow taper essential to prevent rebound
    rxcui 8638
  • pantoprazole
    add on
    ppi_gastric_protection
    40 mg PO daily • PO • daily
    triggers: concurrent_nsaid_or_asa_or_steroid_for_gi_prophylaxis
    GI bleed prophylaxis essential during high-dose ASA / NSAID / steroid therapy; standard of care (ESC 2015)
    rxcui 40790
  • acetaminophen
    add on
    analgesic_antipyretic
    650-1000 mg PO q6h scheduled • PO • q6h scheduled
    triggers: analgesia_adjunct_or_nsaid_contraindicated
    Analgesic adjunct + alternative if NSAID / ASA contraindicated; no anti-inflammatory effect
    rxcui 161
  • normal saline
    first line
    isotonic_crystalloid
    500-1000 mL bolus • IV • rapid bolus then reassess
    triggers: hypotension_pre_drainage_if_tamponade
    Bridge preload to drainage if tamponade physiology develops (ESC 2015)
    rxcui 9863
  • norepinephrine
    rescue
    vasopressor
    0.05-0.1 µg/kg/min titrate to MAP ≥65 • IV • continuous
    triggers: SBP_lt_85_despite_fluids_in_tamponade_variant
    Bridge only if tamponade — does not address obstruction (Roy JAMA 2007)
    rxcui 7512
  • azathioprine
    rescue
    immunosuppressant
    1-1.5 mg/kg PO daily titrate to 2-3 mg/kg/d • PO • daily
    triggers: refractory_recurrent_pericarditis_despite_first_and_second_line, steroid_dependent_with_intolerance_to_steroid_taper
    ESC 2015 — third-line for refractory recurrent pericarditis; requires TPMT testing + LFT + CBC monitoring; consider rheumatology / cardiology multidisciplinary input
    rxcui 1256
  • IL-1 receptor antagonist (anakinra)
    rescue
    biologic_il1_antagonist
    100 mg SC daily • SC • daily × 6 mo then taper
    triggers: refractory_recurrent_pericarditis_with_il1_inflammation_pattern_steroid_dependent
    AIRTRIP trial (Brucato JAMA 2016) — biologic for steroid-dependent refractory recurrent pericarditis; expensive but transformative for this subset; rheumatology / cardiology multidisciplinary input
    rxcui 72435

outpatient playbook — drug actions (5)

  1. 1. complete ASA / NSAID taper at 6-8 wk
    rxcui 1191
    completed • N/A • completed
    trigger: CRP normalized + symptoms resolved
    ESC 2015 — total 6-8 wk anti-inflammatory course typical
  2. 2. complete colchicine 3-mo course
    rxcui 2555
    0.5 mg BID until 3 mo total then discontinue • PO • BID then discontinue
    trigger: End of 3-mo course
    CORP-2 PMID 24239018 — 3-mo cornerstone
  3. 3. extend colchicine if recurrence
    rxcui 2555
    0.5 mg BID extended to 6 mo or longer per CORP • PO • BID extended
    trigger: Recurrence pattern
    CORP PMID 21788540 + CORP-2 PMID 24239018 — extended duration for recurrent pericarditis
  4. 4. restart anti-inflammatory if recurrence
    rxcui 1191
    aspirin 750-1000 mg TID OR ibuprofen 600 mg TID + colchicine extended • PO • TID
    trigger: Recurrent pleuritic pain + fever + CRP elevation
    ESC 2015 — recurrence treatment per CORP
  5. 5. azathioprine or anakinra for refractory recurrent
    rxcui 1256
    azathioprine 1-1.5 mg/kg/d titrate OR anakinra 100 mg SC daily per AIRTRIP • PO or SC • per agent
    trigger: Refractory recurrent pericarditis with steroid dependence
    ESC 2015 + Brucato JAMA 2016 AIRTRIP — third-line biologics for steroid-dependent refractory cases

Auto-drafted A&P note

outpatient

Subjective

- Possible entry pathways: Low-grade fever + pleuritic chest pain (worse supine, better leaning forward) 2-12 weeks post-MI / post-CABG / post-pacemaker / post-ablation → Dressler syndrome / PCIS (ESC 2015 §Post-Cardiac Injury Syndrome; Imazio CIRCS NEJM 2015 PMID 26315582); Recent (2-12 wk) cardiac injury (MI, CABG, valve surgery, lead implant, ablation, blunt trauma) with new friction rub + ESR / CRP elevation (Imazio COPPS PMID 20447948); Echo: new pericardial effusion 2-12 weeks post-cardiac-injury — variable size; tamponade physiology in ~10-20% of cases (ESC 2015 Class I; Imazio JAMA 2014 PMID 25268438).

Objective

- No vitals, labs, or imaging entered for this encounter.

Assessment

**Cardiac tamponade — Dressler syndrome (post-cardiac-injury syndrome)** (cardio.cardiac-tamponade.dressler-syndrome.v1).
Phenotype framing: Differentiate PCIS from: (1) re-infarction (serial troponin trend + cath if rising); (2) infectious pericarditis (no fever pattern + elevated procalcitonin + positive cultures); (3) malignant effusion (cancer history + cytology); (4) uremic pericarditis (CKD context + BUN >100); (5) post-procedural bleeding (no inflammatory markers, anticoagulation context). Pericardial fluid analysis ONLY if tamponade requiring drainage (ESC 2015; Adler 2015 BMJ)
Scope: Dressler syndrome / PCIS — autoimmune pericarditis 2-12 wk post-cardiac-injury; high-dose ASA + colchicine first-line (preferred post-MI); NSAIDs + colchicine alternative (post-surgery); corticosteroids reserved for refractory; pericardiocentesis only if tamponade (~10-20% of cases) (ESC 2015 §Post-Cardiac Injury Syndrome; Imazio CIRCS NEJM 2015 PMID 26315582)

No severity triggers fired against current inputs.

Plan

Regimen axis: **Dressler / PCIS — high-dose ASA + colchicine first-line (preferred post-MI); NSAID + colchicine alternative (post-surgery); corticosteroids reserved for refractory (ESC 2015 §PCIS; Imazio CORP-2 Lancet 2014 PMID 24239018; Imazio ICAP NEJM 2013 PMID 23992557)**.
1. aspirin 750-1000 mg PO TID × 1-2 wk then taper by 250-500 mg q1-2 wk per CRP normalization (total ~6-8 wk) PO TID with food + PPI prophylaxis (salicylate_anti_inflammatory, first line) — ESC 2015 §PCIS — preferred post-MI given continued antiplatelet benefit; high-dose anti-inflammatory effect; PPI prophylaxis essential for GI protection
2. ibuprofen 600 mg PO TID × 1-2 wk then taper to 400 mg TID × 1 wk then 400 mg BID × 1 wk PO TID with food + PPI prophylaxis (nsaid, first line) — Imazio ICAP PMID 23992557 — alternative first-line if post-surgery or non-MI context; equivalent efficacy to ASA
3. indomethacin 25-50 mg PO TID × 1-2 wk then taper PO TID with food + PPI prophylaxis (nsaid, second line) — Alternative NSAID — historically used in PCIS; AVOID in elderly + CHF + CKD due to CV / renal risks (ESC 2015)
4. colchicine 0.5 mg PO BID × 3 mo (0.5 mg daily if weight <70 kg or CrCl 30-60) PO BID × 3 mo (microtubule_inhibitor_anti_inflammatory, first line) — CORP-2 PMID 24239018 + ICAP PMID 23992557 + COPPS-2 PMID 25268438 — RR 0.56 reduction in recurrence; cornerstone of modern PCIS management; ALWAYS combined with first-line anti-inflammatory
5. prednisolone 0.2-0.5 mg/kg/d × 2-4 wk then SLOW taper over 6-8 wk (decrease by 5-10 mg/wk to 25 mg, then 2.5 mg/wk to 15 mg, then 1-2.5 mg q2wk to discontinuation) PO daily with slow taper (corticosteroid, second line) — ESC 2015 — RESERVED for refractory cases or contraindications; LOW-DOSE preferred (0.2-0.5 mg/kg/d) — high-dose steroids INCREASE recurrence risk per CORP-2 + ICAP; very slow taper essential to prevent rebound
6. pantoprazole 40 mg PO daily PO daily (ppi_gastric_protection, add on) — GI bleed prophylaxis essential during high-dose ASA / NSAID / steroid therapy; standard of care (ESC 2015)
7. acetaminophen 650-1000 mg PO q6h scheduled PO q6h scheduled (analgesic_antipyretic, add on) — Analgesic adjunct + alternative if NSAID / ASA contraindicated; no anti-inflammatory effect
8. normal saline 500-1000 mL bolus IV rapid bolus then reassess (isotonic_crystalloid, first line) — Bridge preload to drainage if tamponade physiology develops (ESC 2015)
9. norepinephrine 0.05-0.1 µg/kg/min titrate to MAP ≥65 IV continuous (vasopressor, rescue) — Bridge only if tamponade — does not address obstruction (Roy JAMA 2007)
10. azathioprine 1-1.5 mg/kg PO daily titrate to 2-3 mg/kg/d PO daily (immunosuppressant, rescue) — ESC 2015 — third-line for refractory recurrent pericarditis; requires TPMT testing + LFT + CBC monitoring; consider rheumatology / cardiology multidisciplinary input
11. IL-1 receptor antagonist (anakinra) 100 mg SC daily SC daily × 6 mo then taper (biologic_il1_antagonist, rescue) — AIRTRIP trial (Brucato JAMA 2016) — biologic for steroid-dependent refractory recurrent pericarditis; expensive but transformative for this subset; rheumatology / cardiology multidisciplinary input

Setting playbook (outpatient) — CRP-guided anti-inflammatory taper completion at 6-8 wk; colchicine 3-mo completion; recurrence surveillance (~30% risk); pericardiectomy reserved for rare constrictive sequelae (ESC 2015; Imazio ICAP PMID 23992557)
12. complete ASA / NSAID taper at 6-8 wk completed N/A completed — CRP normalized + symptoms resolved (ESC 2015 — total 6-8 wk anti-inflammatory course typical)
13. complete colchicine 3-mo course 0.5 mg BID until 3 mo total then discontinue PO BID then discontinue — End of 3-mo course (CORP-2 PMID 24239018 — 3-mo cornerstone)
14. extend colchicine if recurrence 0.5 mg BID extended to 6 mo or longer per CORP PO BID extended — Recurrence pattern (CORP PMID 21788540 + CORP-2 PMID 24239018 — extended duration for recurrent pericarditis)
15. restart anti-inflammatory if recurrence aspirin 750-1000 mg TID OR ibuprofen 600 mg TID + colchicine extended PO TID — Recurrent pleuritic pain + fever + CRP elevation (ESC 2015 — recurrence treatment per CORP)
16. azathioprine or anakinra for refractory recurrent azathioprine 1-1.5 mg/kg/d titrate OR anakinra 100 mg SC daily per AIRTRIP PO or SC per agent — Refractory recurrent pericarditis with steroid dependence (ESC 2015 + Brucato JAMA 2016 AIRTRIP — third-line biologics for steroid-dependent refractory cases)

Non-pharmacologic actions:
- Cardiology follow-up at 4 wk + 12 wk + 6 mo then per recurrence
- PCP coordination for medication monitoring
- Cardiac rehab if appropriate (avoid early after MI per ACC/AHA guidelines)
- Patient + family education ongoing for recurrence recognition
- Pregnancy planning counseling if applicable (NSAIDs contraindicated 3rd trimester; colchicine generally safe)

AVOID / contraindication checks:
- Positive_pressure_ventilation_AVOID_pre_drain_if_tamponade (ESC 2015)
- High_dose_steroids_INCREASE_recurrence_risk_use_low_dose_only (CORP 2 PMID 24239018; ICAP PMID 23992557)
- Colchicine_AVOID_egfr_lt_30_or_severe_hepatic_impairment (drug label; ESC 2015)
- Colchicine_dose_reduce_egfr_30_60_to_0.3_mg_daily (drug label; weight <70 kg)
- Colchicine_drug_interactions_strong_cyp3a4_inhibitors_macrolides_p_gp_inhibitors (drug label)
- NSAIDs_AVOID_third_trimester_pregnancy_premature_ductus_closure (drug label)
- NSAIDs_AVOID_active_GI_bleeding_or_severe_CKD (ESC 2015)
- Asa_AVOID_aspirin_allergy_or_active_GI_bleeding_or_thrombocytopenia (drug label)
- NSAIDs_caution_post_MI_increase_thrombotic_risk_prefer_ASA (ACC/AHA STEMI 2025)
- Steroids_taper_slowly_to_prevent_rebound_recurrence (ESC 2015)
- Azathioprine_TPMT_testing_required_pre_initiation (drug label)
- Anakinra_infection_risk_screen_for_TB_and_chronic_infections_pre_initiation (drug label)

Monitoring

Regimen monitoring:
- CRP baseline then q1 2 wk until normalized target lt 1 mg dL guides therapy de escalation (ICAP PMID 23992557)
- echo at 1 wk 4 wk 12 wk for effusion resolution and recurrence surveillance (ESC 2015)
- CBC BMP monthly for colchicine GI and marrow toxicity (drug label)
- LFTs q3 mo for colchicine long term safety (drug label)
- GI symptom screen for NSAID ASA steroid tolerance (ESC 2015)
- continuous ECG during drainage if tamponade (ESC 2015)
- art line BP pre and post if drainage (Adler 2015)
- echo post drain immediate then q24 48h x 7d then weekly if tamponade (ESC 2015)
- symptom log for recurrence pattern (Imazio CORP PMID 21788540)
- TPMT testing pre azathioprine then LFT CBC monthly (drug label)
- TB screen pre anakinra then infection surveillance (drug label)

Setting (outpatient) monitoring:
- CRP at 4 wk + 12 wk then per recurrence
- Echo at 4 wk + 12 wk + 6 mo
- CBC + BMP monthly during colchicine course
- Symptom log

Monitoring phase: CRP trend (target normalization to <1 mg/dL guides therapy de-escalation), echo at 1 wk + 4 wk + 12 wk for resolution + recurrence surveillance, drug tolerance (GI side effects from NSAIDs / ASA, colchicine GI toxicity, steroid side effects if used), recurrence pattern (Imazio CORP / CORP-2 PMID 21788540 / 24239018; Imazio ICAP PMID 23992557)

Disposition

Current setting: outpatient — CRP-guided anti-inflammatory taper completion at 6-8 wk; colchicine 3-mo completion; recurrence surveillance (~30% risk); pericardiectomy reserved for rare constrictive sequelae (ESC 2015; Imazio ICAP PMID 23992557)

Disposition criteria:
- Long-term continuation under cardiology + PCP; biologics if refractory recurrent; pericardiectomy if constriction develops; cross-link to cardio.cardiac-tamponade.core.v1 for acute recurrence pathway

Escalation triggers (move to higher acuity):
- Recurrent pericarditis (≥1 episode after symptom-free interval) → extend colchicine to 6 mo per CORP + restart anti-inflammatory
- Multiple recurrences (≥2 episodes) → CORP-2 protocol + consider rheumatology consult
- Refractory recurrent pericarditis with steroid dependence → azathioprine or anakinra per ESC 2015 + AIRTRIP
- Constrictive pericarditis (rare in PCIS but possible) → CMR + RH cath + cardiothoracic for pericardiectomy
- Tamponade recurrence → ED for echo + drainage

Earlier-Return Triggers

Return-precaution thresholds (watch for):
- [LIFE_THREATENING] Beck triad + echo evidence of tamponade physiology in PCIS patient — ~10-20% of PCIS cases develop tamponade requiring emergent pericardiocentesis (ESC 2015 Class I; Imazio JAMA 2014 PMID 25268438)
- [LIFE_THREATENING] PCIS patient on DAPT or anticoagulation with hemorrhagic effusion + tamponade — emergent reversal + drainage required (ESC 2015; Bhatt Circulation 2018)
- [SEVERE] Post-MI patient (2-12 wk post-event) presenting with chest pain — must differentiate Dressler vs re-infarction (ESC 2015; ACC/AHA STEMI 2025)

Citations

- 2015 ESC Guidelines for the diagnosis and management of pericardial diseases (Adler EHJ 2015 PMID 26320112) §Post-Cardiac Injury Syndrome — remains current as of 2026-05-15. Imazio CORP-2 (Lancet 2014 PMID 24239018) + ICAP (NEJM 2013 PMID 23992557) + COPPS-2 (JAMA 2014 PMID 25268438) + CIRCS (NEJM 2015 PMID 26315582) anchor colchicine 0.5 mg BID × 3 mo cornerstone with RR 0.56 reduction in recurrence; ASA preferred post-MI given antiplatelet benefit; corticosteroids RESERVED for refractory with LOW-dose only to minimize rebound risk. Brucato AIRTRIP (JAMA 2016) anchors anakinra biologic for steroid-dependent refractory recurrent pericarditis. [PMID:26320112](https://pubmed.ncbi.nlm.nih.gov/26320112/)
- Cited evidence (PMID 24239018) [PMID:24239018](https://pubmed.ncbi.nlm.nih.gov/24239018/)
- Cited evidence (PMID 23992557) [PMID:23992557](https://pubmed.ncbi.nlm.nih.gov/23992557/)
- Cited evidence (PMID 21788540) [PMID:21788540](https://pubmed.ncbi.nlm.nih.gov/21788540/)
- Cited evidence (PMID 25268438) [PMID:25268438](https://pubmed.ncbi.nlm.nih.gov/25268438/)

Last reconciled with current guidelines: 2026-05-15.
References
  • 2015 ESC Guidelines for the diagnosis and management of pericardial diseases (Adler EHJ 2015 PMID 26320112) §Post-Cardiac Injury Syndrome — remains current as of 2026-05-15. Imazio CORP-2 (Lancet 2014 PMID 24239018) + ICAP (NEJM 2013 PMID 23992557) + COPPS-2 (JAMA 2014 PMID 25268438) + CIRCS (NEJM 2015 PMID 26315582) anchor colchicine 0.5 mg BID × 3 mo cornerstone with RR 0.56 reduction in recurrence; ASA preferred post-MI given antiplatelet benefit; corticosteroids RESERVED for refractory with LOW-dose only to minimize rebound risk. Brucato AIRTRIP (JAMA 2016) anchors anakinra biologic for steroid-dependent refractory recurrent pericarditis. — PMID:26320112
  • Cited evidence (PMID 24239018) — PMID:24239018
  • Cited evidence (PMID 23992557) — PMID:23992557
  • Cited evidence (PMID 21788540) — PMID:21788540
  • Cited evidence (PMID 25268438) — PMID:25268438