Racial Difference in Sarcoidosis Mortality in the United States

Mirsaeidi, Mehdi; Machado, Roberto F.; Schraufnagel, Dean E.; Sweiss, Nadera J.; Baughman, Robert P.

doi:10.1378/chest.14-1120

Cited by 175 publications

(133 citation statements)

References 24 publications

(27 reference statements)

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“…We expand on their work by using the NIS with propensity matching on a number of demographic and clinical variables to help further define the increased risk of mortality in blacks with sarcoidosis. Mirsaiedi et al also reported that incident cardiac arrest occurred at a higher rate in blacks compared with whites 9. This is consistent with our study findings in a much larger sample, making it more generalizable.…”

Section: Discussionsupporting

confidence: 92%

“…Mirsaeidi et al9 previously reported that blacks have a mortality rate that is 12 times higher than whites with sarcoidosis in their age‐adjusted model. Their investigation used the Centers for Disease Control and Prevention database with evaluating death certificate (the immediate cause of death) in patients with sarcoidosis 9. We expand on their work by using the NIS with propensity matching on a number of demographic and clinical variables to help further define the increased risk of mortality in blacks with sarcoidosis.…”

Section: Discussionmentioning

confidence: 93%

“…Demographic factors such as older age,29 male sex,33 and black race9 were associated with in‐hospital mortality. Our findings are in agreement with an informative study that examined sarcoidosis mortality from 1988 to 2007 at a population level using data from the National Center for Health Statistics 34.…”

Section: Discussionmentioning

confidence: 98%

“…We queried the NIS database using the ICD‐9‐CM diagnostic code of 135 for sarcoidosis in the primary or secondary diagnosis fields 9, 18, 19. Hospitalizations with any present or past history of myocardial infarction, coronary artery disease, or ischemic cardiomyopathy were excluded using ICD‐9‐CM diagnostic codes to avoid influence of ischemic heart disease on trends and outcomes (Table S1).…”

Section: Methodsmentioning

confidence: 99%

“…Patients with sarcoidosis with concomitant cardiovascular manifestations have more complications and a greater risk of sudden death 7, 8. Thus, there is considerable interest in identifying patients with sarcoidosis with concomitant cardiovascular manifestations 9, 10…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Hospitalization Rates, Prevalence of Cardiovascular Manifestations, and Outcomes Associated With Sarcoidosis in the United States

Patel

Kalra

Doshi

et al. 2018

JAHA

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BackgroundRecent trends of hospitalizations and in‐hospital mortality are not well defined in sarcoidosis. We examined aforementioned trends and prevalence of cardiovascular manifestations and explored rates of implantable cardioverter‐defibrillator implantation in hospitalizations with sarcoidosis.Methods and ResultsUsing data from the National Inpatient Sample, a retrospective population cohort from 2005 to 2014 was studied. To identify sarcoidosis, an International Classification of Diseases, Ninth Revision, Clinical Modification (ICD‐9‐CM) diagnosis code was used. We excluded hospitalizations with myocardial infarction, coronary artery disease, and ischemic cardiomyopathy. Cardiovascular manifestations were defined by the presence of diagnosis codes for conduction disorders, arrhythmias, heart failure, nonischemic cardiomyopathy, and pulmonary hypertension. A total of 609 051 sarcoidosis hospitalizations were identified, with an age of 55±14 years, 67% women, and 50% black. The number of sarcoidosis hospitalizations increased from 2005 through 2014 (138 versus 175 per 100 000, P trend<0.001). We observed declining trends of unadjusted in‐hospital mortality (6.5 to 4.9 per 100 sarcoidosis hospitalizations, P trend<0.001). Overall ≈31% (n=188 438) of sarcoidosis hospitalizations had coexistent cardiovascular manifestations of one or more type. Heart failure (≈16%) and arrhythmias (≈15%) were the most prevalent cardiovascular manifestations. Rates of implantable cardioverter‐defibrillator placement were ≈7.5 per 1000 sarcoidosis hospitalizations (P trend=0.95) during the study period. Black race was associated with 21% increased risk of in‐hospital mortality (odds ratio, 1.21; 95% confidence interval, 1.16–1.27 [P<0.001]).ConclusionsSarcoidosis hospitalizations have increased over the past decade with a myriad of coexistent cardiovascular manifestations. Black race is a significant predictor of in‐hospital mortality, which is declining. Further efforts are needed to improve care in view of low implantable cardioverter‐defibrillator rates in sarcoidosis.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 98%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Hospitalization Rates, Prevalence of Cardiovascular Manifestations, and Outcomes Associated With Sarcoidosis in the United States

Patel

Kalra

Doshi

et al. 2018

JAHA

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Racial Differences in Multimorbidity and Comorbidities in Rheumatoid Arthritis

Kronzer

Dykhoff

Stevens

et al. 2022

Arthritis Care & Research

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Objective To identify differences in multimorbidity and individual comorbidities among individuals with rheumatoid arthritis (RA), separated by race and ethnicity. Methods This case–control study within OptumLabs Data Warehouse from 2010 to 2019 matched RA cases (defined by 2 codes plus prescription of an RA drug) to non‐RA controls 1:1 on age, sex, race and ethnicity, region, index date of RA, and insurance coverage duration. We defined multimorbidity as the presence of ≥2 or ≥5 validated comorbidities. Logistic regression models calculated adjusted odds of multimorbidity with 95% confidence intervals (95% CIs) within each race and ethnicity. Results We identified 154,391 RA cases and 154,391 controls (mean age 59.6, 76% female). Black enrollees had the most multimorbidity ≥2/≥5 (73.1%, 34.3%); Asian enrollees had the least (52.4%, 17.3%). Adjusted odds of multimorbidity ≥2 and ≥5 in RA cases versus controls was 2.19 (95% CI 2.16–2.23) and 2.06 (95% CI 2.02–2.09), respectively. This increase was similar across race and ethnicity. However, we observed elevated occurrence of certain comorbidities by race and ethnicity versus controls (P < 0.001), including renal disease in White enrollees (4.7% versus 3.2%) and valvular heart disease in Black and White enrollees (3.2% and 2.8% versus 2.6% and 2.2%). Conclusion Multimorbidity is a problem for all RA patients. Targeted identification of certain comorbidities by race and ethnicity may be a helpful approach to mitigate multimorbidity.

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Activity of the growth hormone‐releasing hormone antagonist MIA602 and its underlying mechanisms of action in sarcoidosis‐like granuloma

et al. 2021

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Objectives. Growth hormone-releasing hormone (GHRH) is a potent stimulator of growth hormone (GH) secretion from the pituitary gland. Although GHRH is essential for the growth of immune cells, the regulatory effects of its antagonist in granulomatous disease remain unknown. Methods. Here, we report expression of GHRH receptor (R) in human tissue with sarcoidosis granuloma and demonstrate the anti-inflammatory effects of MIA602 (a GHRH antagonist) in two in vitro human granuloma models and an in vivo granuloma model using different methods including ELISA, immunohistochemistry, RNAseq analysis and flow cytometry. Results. MIA602 decreases the levels of IL-2, IL-2R, IL-7, IL-12, IL-17A and TNF-a in an in vitro granuloma model. Further, we show that the anti-inflammatory effect of MIA602 appears to be mediated by a reduction in CD45 + CD68 + cells in granulomatous tissue and upregulation in PD-1 expression in macrophages. Analysis of the expression of proteins involved in the mitochondrial stage of apoptosis showed that MIA602 increases the levels of caspase-3, BCL-xL/BAK dimer and MCl-1/Bak dimer in the granuloma. These findings indicate that MIA602 may not induce apoptosis. Conclusions. Our findings further suggest that GHRH-R is potentially a clinical target for the treatment of granulomatous disease and that MIA602 may be used as a novel therapeutic agent for sarcoidosis.

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Racial Difference in Sarcoidosis Mortality in the United States

Abstract: This nationwide population-based study exposes a significant difference in ethnicity and sex among people dying of sarcoidosis in the United States. Pulmonary hypertension investigation should be considered in all patients with sarcoidosis, especially African Americans.

Cited by 175 publications

References 24 publications

Hospitalization Rates, Prevalence of Cardiovascular Manifestations, and Outcomes Associated With Sarcoidosis in the United States

Hospitalization Rates, Prevalence of Cardiovascular Manifestations, and Outcomes Associated With Sarcoidosis in the United States

Racial Differences in Multimorbidity and Comorbidities in Rheumatoid Arthritis

Activity of the growth hormone‐releasing hormone antagonist MIA602 and its underlying mechanisms of action in sarcoidosis‐like granuloma

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