Cardiac events more common in isolated vs systemic cardiac sarcoidosis

Despite having clinical features similar to that of systemic cardiac sarcoidosis (SCS), patients with isolated CS (ICS) see a higher rate of cardiac events, a recent study has found.

The study included 286 patients with suspected CS, in whom SCS was diagnosed through histological or clinical confirmation according to guidelines, while ICS was confirmed though heart findings alone. The study endpoints were cardiac death, hospitalization for heart failure, or fatal ventricular arrhythmia.

Twenty-one patients were deemed to have ICS, while SCS was confirmed in 63 participants; the remaining 202 were found to not have CS.

Over a median follow-up of 31 months, the researchers documented one death, nine hospitalizations for heart failure, and four fatal ventricular arrhythmias in ICS patients. In comparison, two deaths, 12 hospitalizations for heart failure, and 10 fatal ventricular arrhythmias were detected in SCS patients. Kaplan-Meier analysis found that all three events occurred at significantly higher rates in ICS patients (log-rank p=0.01).

Such findings were confirmed by Cox proportional hazards analysis, which found that ICS was indeed significantly correlated with cardiac events (hazard ratio [HR], 2.09, 95 percent confidence interval [CI], 1.12–3.62; p=0.02). Other notable risk factors included age (HR, 2.23, 95 percent CI, 1.47–3.46; p<0.01) and New York Heart Association functional class III or IV (HR, 1.55, 95 percent CI, 1.02–2.38; p=0.04).

“To the best of our knowledge, this is the first study to show clinical outcomes in patients with isolated CS diagnosed by clinical diagnostic criteria,” the researchers said.