Long-Term Adverse Cardiac Outcomes in Patients With Sarcoidosis

Yafasova, Adelina; Fosbøl, Emil Loldrup; Schou, Morten; Gustafsson, Finn; Rossing, Kasper; Bundgaard, Henning; Lauridsen, Marie Dam; Kristensen, Søren Lund; Torp‐Pedersen, Christian; Gislason, Gunnar; Køber, Lars; Butt, Jawad H

doi:10.1016/j.jacc.2020.06.038

Cited by 67 publications

(56 citation statements)

References 40 publications

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“…This observation was in line with previous investigations. [3][4][5] The highest rates of HF were observed in individuals ≥65 years old and in those with a history of IHD/AMI, but HF was also seen in younger patients with sarcoidosis and in those without a history of IHD. These findings together with an increased HR of HF…”

Section: Discussionmentioning

confidence: 99%

“…1 In sarcoidosis, a systemic granulomatous disease of unknown aetiology, HF is a common cause of excess mortality. 2 Recently, studies showed that rates of HF are about twofold higher in sarcoidosis compared with the general population, [3][4][5] with more than sevenfold higher risks observed close to sarcoidosis diagnosis. 4 It remains unknown, however, which patients are at the highest risk of HF and may benefit most from preventive interventions.…”

Section: Introductionmentioning

confidence: 99%

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Risk and predictors of heart failure in sarcoidosis in a population-based cohort study from Sweden

Rossides

Kullberg

Grünewald

et al. 2021

Heart

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ObjectivesPrevious studies showed a strong association between sarcoidosis and heart failure (HF) but did not consider risk stratification or risk factors to identify useful aetiological insights. We estimated overall and stratified HRs and identified risk factors for HF in sarcoidosis.MethodsSarcoidosis cases were identified from the Swedish National Patient Register (NPR; ≥2 International Classification of Diseases-coded visits, 2003–2013) and matched to general population comparators. They were followed for HF in the NPR. Treated were cases who were dispensed ≥1 immunosuppressant ±3 months from the first sarcoidosis visit (2006–2013). Using Cox models, we estimated HRs adjusted for demographics and comorbidity and identified independent risk factors of HF together with their attributable fractions (AFs).ResultsDuring follow-up, 204 of 8574 sarcoidosis cases and 721 of 84 192 comparators were diagnosed with HF (rate 2.2 vs 0.7/1000 person-years, respectively). The HR associated with sarcoidosis was 2.43 (95% CI 2.06 to 2.86) and did not vary by age, sex or treatment status. It was higher during the first 2 years after diagnosis (HR 3.7 vs 1.9) and in individuals without a history of ischaemic heart disease (IHD; HR 2.7 vs 1.7). Diabetes, atrial fibrillation and other arrhythmias were the strongest independent clinical predictors of HF (HR 2.5 each, 2-year AF 20%, 16% and 12%, respectively).ConclusionsAlthough low, the HF rate was more than twofold increased in sarcoidosis compared with the general population, particularly right after diagnosis. IHD history cannot solely explain these risks, whereas ventricular arrhythmias indicating cardiac sarcoidosis appear to be a strong predictor of HF in sarcoidosis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Risk and predictors of heart failure in sarcoidosis in a population-based cohort study from Sweden

Rossides

Kullberg

Grünewald

et al. 2021

Heart

View full text Add to dashboard Cite

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“…Ungprasert et al observed a high incidence of cardiovascular disease in patients with sarcoidosis [5]. In a large cohort study reported by Yafasova et al, patients diagnosed with sarcoidosis showed a high risk of heart failure and other adverse cardiac events [6]. However, whether patients with pulmonary sarcoidosis without cardiac involvement also show a high risk of poor cardiac outcomes remains unknown.…”

Section: Discussionmentioning

confidence: 99%

Sudden Cardiac Arrest in a Patient With Sarcoidosis and Familial Hypercholesterolemia

Sugimoto¹,

Takeuchi²,

Taniguchi³

et al. 2021

Cureus

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A 32-year-old Japanese man experienced out-of-hospital cardiac arrest. On arrival, computed tomography (CT) showed ground-glass opacity in the right lung. Emergency coronary angiography revealed triple vessel disease, then he underwent percutaneous coronary intervention. We also diagnosed him with heterozygous familial hypercholesterolemia and administered rosuvastatin and evolocumab. His clinical course was uncomplicated, and he was discharged on the 21st day of admission. Follow-up CT performed two years later revealed multiple areas of consolidation with sarcoid galaxy sign and mediastinal lymphadenopathy. We diagnosed him with pulmonary sarcoidosis by histopathological evaluation of the biopsied specimen via endobronchial ultrasound-guided transbronchial fine-needle aspiration of enlarged subcarinal lymph nodes. After we administered oral prednisolone with a gradual taper, his CT findings improved.

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“…A recent Danish nationwide cohort study of 11,834 patients with sarcoidosis and 47,336 control subjects underscored that sarcoidosis is associated with higher long-term risk of incident heart failure, higher mortality among the subjects who develop heart failure, and higher long-term risk of adverse cardiac outcomes, when compared to the background population, thus warranting for awareness and increased diagnostic performance [123].…”

Section: Implications Of Multimodality Imaging In Sarcoidosismentioning

confidence: 99%

The Importance of Multimodality Imaging in the Diagnosis and Management of Patients with Infiltrative Cardiomyopathies: An Update

et al. 2021

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Infiltrative cardiomyopathies (ICMs) comprise a broad spectrum of inherited and acquired conditions (mainly amyloidosis, sarcoidosis, and hemochromatosis), where the progressive buildup of abnormal substances within the myocardium results in left ventricular hypertrophy and manifests as restrictive physiology. Noninvasive multimodality imaging has gradually eliminated endomyocardial biopsy from the diagnostic workup of infiltrative cardiac deposition diseases. However, even with modern imaging techniques’ widespread availability, these pathologies persist in being largely under- or misdiagnosed. Considering the advent of novel, revolutionary pharmacotherapies for cardiac amyloidosis, the archetypal example of ICM, a standardized diagnostic approach is warranted. Therefore, this review aims to emphasize the importance of contemporary cardiac imaging in identifying specific ICM and improving outcomes via the prompt initiation of a targeted treatment.

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Long-Term Adverse Cardiac Outcomes in Patients With Sarcoidosis

Cited by 67 publications

References 40 publications

Risk and predictors of heart failure in sarcoidosis in a population-based cohort study from Sweden

Risk and predictors of heart failure in sarcoidosis in a population-based cohort study from Sweden

Sudden Cardiac Arrest in a Patient With Sarcoidosis and Familial Hypercholesterolemia

The Importance of Multimodality Imaging in the Diagnosis and Management of Patients with Infiltrative Cardiomyopathies: An Update

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