Patients with sarcoidosis may have an increased risk of heart failure and other adverse outcomes, including all-cause mortality, according to an observational study published in the Journal of the American College of Cardiology.
Sarcoidosis is an inflammatory disease that affects multiple organs in the body, but mostly the lungs and lymph glands. In people with sarcoidosis, abnormal masses or nodules (called granulomas) consisting of inflamed tissues form in certain organs of the body.
The long-term risk of cardiac outcomes was assessed by including the incident heart failure; a composite of implantable cardioverter-defibrillator (ICD) implantation, ventricular arrhythmias or cardiac arrest; and all-cause mortality in patients with sarcoidosis.
The team analysed data from 12,883 Danish residents of 18 years or older who were diagnosed with sarcoidosis from 1996 to 2016. Patients with any history of cardiac events were excluded.
Of the diagnosed patients, 11,834 were matched with subjects from a nationwide background population of more than 47,000 based on age, sex, and comorbidity. The median age of both populations was 42.8 (33.1-55.8) and 54.3% were men.
Median follow-up was 8.2 years for the sarcoidosis population and 8.4 years for the background population. The absolute 10-year risk of heart failure was 3.18% for sarcoidosis patients and 1.72% for their matched controls.
The 10-year risk for the composite of ICD implantation, ventricular arrhythmias and cardiac arrest was 0.96% for sarcoidosis patients and 0.45% for the background population.
For all-cause mortality, the 10-year risk was 10.88% for sarcoidosis patients and 7.43% for the background population. In a secondary analysis that compared all-cause mortality between the 364 sarcoidosis patients who developed heart failure and the 1,456 patients with heart failure without a history of sarcoidosis, the sarcoidosis group had a 35% higher rate than the nonsarcoidosis group.
“It’s not necessarily surprising that sarcoidosis patients would have a higher rate of heart failure..But the key takeaway is that sarcoidosis was associated with a higher rate of all-cause mortality compared to patients with heart failure and no sarcoidosis.” said Melissa A Lyle, MD, of the Mayo Clinic in Jacksonville, Fla., in an interview.
However, the researchers also stressed that the study’s Danish population may not be representative of other general populations because of notable differences in ethnicity, age, and comorbidities.
The findings emphasised the need for monitoring for cardiac manifestations in patients with systemic sarcoidosis.