Author + information
- Received April 27, 2020
- Revision received June 10, 2020
- Accepted June 12, 2020
- Published online August 10, 2020.
- Adelina Yafasova, MBa,∗ (, )@adelinayafasova,
- Emil L. Fosbøl, MD, PhDa,
- Morten Schou, MD, PhDb,
- Finn Gustafsson, MD, DMSca,
- Kasper Rossing, MD, PhDa,
- Henning Bundgaard, MD, DMSca,
- Marie D. Lauridsen, MDa,
- Søren L. Kristensen, MD, PhDa,
- Christian Torp-Pedersen, MD, DMScc,
- Gunnar H. Gislason, MD, PhDb,d,e,
- Lars Køber, MD, DMSca and
- Jawad H. Butt, MDa
- aDepartment of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
- bDepartment of Cardiology, Herlev and Gentofte University Hospital, Herlev, Denmark
- cDepartment of Cardiology, Nordsjællands Hospital, Hillerød, Denmark
- dThe National Institute of Public Health, University of Southern Denmark, Odense, Denmark
- eThe Danish Heart Foundation, Copenhagen, Denmark
- ↵∗Address for correspondence:
Dr. Adelina Yafasova, Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, 2100 København Ø, Denmark.
Background It is estimated that 5% of patients with sarcoidosis have clinically manifest cardiac involvement, although autopsy and imaging studies suggest a significantly higher prevalence of cardiac involvement. There is a paucity of contemporary data on the risk of adverse cardiac outcomes, particularly heart failure (HF), in patients with sarcoidosis.
Objectives The purpose of this study was to examine the long-term risk of HF and other adverse cardiac outcomes in patients with sarcoidosis compared with matched control subjects.
Methods In this cohort study, all patients age ≥18 years with newly diagnosed sarcoidosis (1996 to 2016) were identified through Danish nationwide registries and matched 1:4 by age, sex, and comorbidities with control subjects from the background population without sarcoidosis.
Results Of the 12,042 patients diagnosed with sarcoidosis, 11,834 patients were matched with 47,336 subjects from the background population (median age: 42.8 years [25th to 75th percentile: 33.1 to 55.8 years], 54.3% men). The median follow-up was 8.2 years. Absolute 10-year risks of outcomes were as follows: HF: 3.18% (95% confidence interval [CI]: 2.83% to 3.57%) for sarcoidosis patients and 1.72% (95% CI: 1.58% to 1.86%) for the background population; the composite of ICD implantation, ventricular arrhythmias, and cardiac arrest: 0.96% (95% CI: 0.77% to 1.18%) for sarcoidosis patients and 0.45% (95% CI: 0.38% to 0.53%) for the background population; the composite of pacemaker implantation, atrioventricular block, and sinoatrial dysfunction: 0.94% (95% CI: 0.75% to 1.16%) for sarcoidosis patients and 0.51% (95% CI: 0.44% to 0.59%) for the background population; atrial fibrillation or flutter: 3.44% (95% CI: 3.06% to 3.84%) for sarcoidosis patients and 2.66% (95% CI: 2.49% to 2.84%) for the background population; and all-cause mortality: 10.88% (95% CI: 10.23% to 11.55%) for sarcoidosis patients and 7.43% (95% CI: 7.15% to 7.72%) for the background population.
Conclusions Patients with sarcoidosis had a higher associated risk of HF and other adverse cardiac outcomes compared with matched control subjects.
The authors have reported that they have no relationships relevant to the contents of this paper to disclose.
The authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the JACC author instructions page.
- Received April 27, 2020.
- Revision received June 10, 2020.
- Accepted June 12, 2020.
- 2020 American College of Cardiology Foundation
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