Perspective:

This nationwide study using Danish patients with sarcoidosis shows the extent to which the diagnosis of sarcoidosis increases risk of adverse cardiac outcomes compared with the background population. Across the board, the diagnosis of sarcoidosis was associated with increased risk of HF, ventricular arrhythmia, cardiac arrest, atrioventricular block, sinoatrial dysfunction, atrial fibrillation or flutter, and mortality. Formal diagnosis of cardiac sarcoidosis (i.e., cardiac infiltration by sarcoidosis) was not captured in the database, but the incidence of hypertension and atherosclerotic disease was actually lower in the sarcoidosis cohort, suggesting that cardiac sarcoidosis may indeed have been the underlying cause of adverse events in these patients. Likewise, it is not clear whether the specific diagnosis would have been delayed in these patients. Nonetheless, the findings underline the need for monitoring of patients with sarcoidosis for possible cardiac involvement.