Patients with sarcoidosis have a substantially higher associated long-term risk of adverse cardiac outcomes, including heart failure (HF), according to a study published Aug. 10 in the Journal of the American College of Cardiology.

Adelina Yafasova, MB, et al., sought to examine the long-term risk of HF and other adverse cardiac outcomes in patients with sarcoidosis compared with matched controls. Researchers identified all patients ≥18 years with newly diagnosed sarcoidosis (1996 to 2016) through Danish nationwide registries. These patients were matched 1:4 by age, sex and comorbidities with controls from the background population without sarcoidosis.

Of the 12,042 patients eligible for matching, 11,834 patients were matched with 47,336 individuals from the background population (median age, 42.6 years, 54.3% men). The median follow-up was 8.2 years. Results showed absolute 10-year risk of outcomes were:

• HF: 3.18% for sarcoidosis patients and 1.72% for controls.
• Composite of ICD implantation, ventricular arrhythmias and cardiac arrest: 0.96% for sarcoidosis patients and 0.45% for controls.
• Composite of pacemaker implantation, atrioventricular block and sinoatrial dysfunction: 0.94% for sarcoidosis patients and 0.51% for controls.
• Atrial fibrillation or flutter: 3.44% for sarcoidosis patients and 2.66% for controls.
• All-cause mortality: 10.88% for sarcoidosis patients and 7.43% for controls.

"[Patients] with sarcoidosis developing HF had a higher associated mortality than patients with HF without a history of sarcoidosis," write the authors of the study. "These findings warrant further large-scale studies on the risk and prognosis associated with adverse cardiac outcomes in patients with sarcoidosis, including patients with confirmed cardiac sarcoidosis."

"These findings support the need for monitoring for cardiac manifestations in patients with systemic sarcoidosis," write Melissa A. Lyle, MD, FACC, and Leslie T. Cooper Jr., MD, FACC, in an accompanying editorial comment. "Future management guidelines for cardiac sarcoidosis should include these data for developing recommendations regarding the role of advanced imaging modalities and biopsy for diagnosis, prognosis, and treatment."

Clinical Topics: Arrhythmias and Clinical EP, Cardiovascular Care Team, Heart Failure and Cardiomyopathies, Implantable Devices, EP Basic Science, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Acute Heart Failure

Keywords: Atrial Fibrillation, Atrioventricular Block, Follow-Up Studies, Denmark, Cardiomyopathies, Sarcoidosis, Heart Failure, Prognosis, Heart Arrest, Biopsy, Registries, Pacemaker, Artificial

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