Association Between Sarcoidosis and Atrial Fibrillation Among Californians Using Medical Care

Rosenthal, David G.; Fang, Christina; Groh, Christopher A.; Nah, Gregory; Vittinghoff, Eric; Dewland, Thomas A.; Marcus, Gregory M.

doi:10.1016/j.jacep.2021.09.006

Cited by 3 publications

(7 citation statements)

References 3 publications

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“…Considering patients with systemic sarcoidosis (not limited to CS), a study based on the Office of Statewide Health Planning and Development California State Databases including 19 225 patients with systemic sarcoidosis found that 44% (95% CI, 31–57%) of the increased mortality could be explained by AF. 33 These results support our findings that the presence of AF in patients with CS increased the risk of adverse events.…”

Section: Discussionsupporting

confidence: 89%

“… 28 The same findings have been reported in patients with systemic sarcoidosis; furthermore, after adjustment, patients were found to have a risk of developing AF 10-fold higher than that of people without sarcoidosis. 33 Our data suggested that the prevalence of AF in patients with CS at the time of diagnosis is much higher than previously expected, and that AF may be an overlooked or underestimated comorbidity.…”

Section: Discussioncontrasting

confidence: 39%

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Prevalence and prognostic value of atrial fibrillation in patients with cardiac sarcoidosis

Fujimoto,

Matsue,

Maeda

et al. 2023

European Heart Journal Open

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Aims The prognostic value of the presence of atrial fibrillation in patients at the time of cardiac sarcoidosis diagnosis is unknown. This study aimed to investigate the association between atrial fibrillation at the time of cardiac sarcoidosis diagnosis and patient prognosis. Methods and Results This study is a post-hoc analysis of Illustration of the Management and Prognosis of Japanese Patients with Cardiac Sarcoidosis (ILLUMINATE-CS), a multicentre, retrospective observational study that evaluated the clinical characteristics and prognosis of patients with cardiac sarcoidosis. The primary endpoint was the combined endpoint of all-cause death and hospitalisation due to heart failure. After excluding patients with missing data about atrial fibrillation status, 445 patients (62 ± 11 years, 36% males) diagnosed with cardiac sarcoidosis according to the Japanese current diagnostic guideline were analysed. Compared to patients without atrial fibrillation, patients with atrial fibrillation (n = 46, 10%) had higher levels of brain natriuretic peptide and higher prevalence of heart failure hospitalisations. During a median follow-up period of 3.2 years (interquartile range, 1.7–5.8 years), 80 primary endpoints were observed. Kaplan–Meier curve analysis indicated that concomitant atrial fibrillation at the time of diagnosis was significantly associated with a high incidence of primary endpoints (log-rank P = 0.002). This association was retained after adjusting for known risk factors including log-transformed brain natriuretic peptide levels and left ventricular ejection fractions (HR, 1.96 [95% confidence interval, 1.05–3.65]; P = 0.035). Conclusion The presence of atrial fibrillation at the time of cardiac sarcoidosis diagnosis is associated with higher incidence of all-cause death and heart failure hospitalisation.

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Section: Discussionsupporting

confidence: 89%

Section: Discussioncontrasting

confidence: 39%

Prevalence and prognostic value of atrial fibrillation in patients with cardiac sarcoidosis

Fujimoto,

Matsue,

Maeda

et al. 2023

European Heart Journal Open

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“…Despite an increased risk of AF and greater comorbidity burden among patients with sarcoidosis, our study suggests that patients with sarcoidosis and AF did not experience poorer in-hospital outcomes when compared to patients without sarcoidosis. 6 AF in sarcoidosis was hypothesized to be caused by atrium granuloma leading to scarring and by sarcoid involvement of the lungs and left ventricle, resulting in increased end-diastolic pressure. 6 , 8 The non-inferior outcomes observed in sarcoidosis provide a reflection of contemporary real-world data on the effectiveness of AF management in sarcoidosis by early diagnosis and treatment of cardiac sarcoidosis as well as early intervention, including rate control, rhythm control, or even catheter ablation, as per guideline in all AF patients regardless of the underlying etiology.…”

Section: Discussionmentioning

confidence: 99%

“… 6 AF in sarcoidosis was hypothesized to be caused by atrium granuloma leading to scarring and by sarcoid involvement of the lungs and left ventricle, resulting in increased end-diastolic pressure. 6 , 8 The non-inferior outcomes observed in sarcoidosis provide a reflection of contemporary real-world data on the effectiveness of AF management in sarcoidosis by early diagnosis and treatment of cardiac sarcoidosis as well as early intervention, including rate control, rhythm control, or even catheter ablation, as per guideline in all AF patients regardless of the underlying etiology. 5 , 9 , 10 Our study also demonstrates that sarcoidosis is not an independent risk factor of in-hospital adverse events during hospitalization.…”

Section: Discussionmentioning

confidence: 99%

Impact of Sarcoidosis on In-hospital Outcomes Among Patients with Atrial Fibrillation: A Nationwide Readmissions Database Analysis

TAN,

ANG,

YEO

et al. 2024

J Innov Cardiac Rhythm Manage.

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Sarcoidosis is a disease that involves multiple organs, including the cardiovascular system. While cardiac sarcoidosis has been increasingly recognized, the impact of sarcoidosis on atrial fibrillation (AF) is not well established. This study aimed to analyze the impact of sarcoidosis on in-hospital outcomes among patients who were admitted for a primary diagnosis of AF. Using the all-payer, nationally representative Nationwide Readmissions Database, our study included patients aged ≥18 years who were admitted for AF between 2017–2020. We stratified the cohort into two groups depending on the presence of sarcoidosis diagnosis. The in-hospital outcomes were assessed between the two groups via propensity score analysis. A total of 1031 (0.27%) AF patients with sarcoidosis and 387,380 (99.73%) AF patients without sarcoidosis were identified in our analysis. Our propensity score analysis of 1031 (50%) patients with AF and sarcoidosis and 1031 (50%) patients with AF but without sarcoidosis revealed comparable outcomes in early mortality (1.55% vs. 1.55%, P = 1.000), prolonged hospital stay (9.51% vs. 9.70%, P = .874), non-home discharge (7.95% vs. 9.89%, P = .108), and 30-day readmission (13.29% vs. 13.69%, P = .797) between the two groups. The cumulative cost of hospitalization was also similar in both groups ($12,632.25 vs. $12,532.63, P = .839). The in-hospital adverse event rates were comparable in both groups. Sarcoidosis is not a risk factor for poorer in-hospital outcomes following AF admission. These findings provide valuable insights into the effectiveness of the current guideline for AF management in patients with concomitant sarcoidosis and AF.

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“…Patients with sarcoidosis are at increased risk for AF. 17 , 18 , 19 A recent investigation among over 20 million California residents showed that patients with sarcoidosis had a 10-fold higher risk of developing incidental AF, compared to the risk in a healthy population. 18 The presence of pulmonary hypertension secondary to lung involvement, chronic activated inflammatory response, and treatment with high-dose corticosteroids may all contribute to the development of AF in this population.…”

Section: Discussionmentioning

confidence: 99%

Incidence of Atrial Fibrillation as the Initial Manifestation of Cardiac Sarcoidosis: Insights From a Catheter Ablation Registry

Bortoli¹,

Weng²,

Tavoosi³

et al. 2023

CJC Open

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Association Between Sarcoidosis and Atrial Fibrillation Among Californians Using Medical Care

Cited by 3 publications

References 3 publications

Prevalence and prognostic value of atrial fibrillation in patients with cardiac sarcoidosis

Prevalence and prognostic value of atrial fibrillation in patients with cardiac sarcoidosis

Impact of Sarcoidosis on In-hospital Outcomes Among Patients with Atrial Fibrillation: A Nationwide Readmissions Database Analysis

Incidence of Atrial Fibrillation as the Initial Manifestation of Cardiac Sarcoidosis: Insights From a Catheter Ablation Registry

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