Key result
Sarcoidosis linked to ~40% higher risk of CIED implantation, cardiac arrest, or SCD.
Why the study?
Longitudinal outcome data for cardiac sarcoidosis remain limited, and the burden of major cardiac electrical events in sarcoidosis patients without overt cardiac involvement is less well defined.
Cohort (n=10,492)
Yes
Patients with sarcoidosis face a 40% higher long-term risk of major cardiac electrical events (CIED implantation, sudden cardiac death, or cardiac arrest) compared to matched general population controls, even when overt cardiac involvement is rare.
May warrant arrhythmia surveillance in sarcoidosis; extends prior associations to long-term matched population data.
Background Cardiac sarcoidosis is associated with clinically important conduction disease and ventricular arrhythmias, yet longitudinal outcome data remain limited. A key evidence gap concerns electrical risk in sarcoidosis patients who lack overt cardiac involvement, in whom the burden of major electrical events is less well defined. Objectives To quantify the long-term risk of major cardiac electrical outcomes among patients with sarcoidosis compared with the general population (matched controls), and to identify predictors of adverse electrical outcomes within the sarcoidosis cohort. Methods We performed a retrospective, nationwide, population-based matched cohort study using Clalit Health Services electronic records. Adults with sarcoidosis (2000–2022) were matched 1:1 to controls by age, sex, and residence; propensity score matching was then applied to balance cardiometabolic and cardiac comorbidities. The primary outcome was a composite of cardiac implantable electronic device (CIED) implantation, sudden cardiac death, or cardiac arrest. Follow-up continued through December 31, 2024; risk estimates were derived using Cox regression models. Results The initial cohort included 6,038 sarcoidosis patients and 6,038 matched controls; after propensity matching, 5,246 pairs remained. Cardiac involvement was documented in 2.5% of sarcoidosis patients. Over a median follow-up of 11.1 years (IQR 5.6–17.8), the composite outcome incidence was 2.31 vs 1.93 per 1,000 person-years (sarcoidosis vs controls), corresponding to a higher adjusted risk (aHR 1.40, 95% CI 1.12–1.75). Associations were stronger among women (aHR 1.60) and patients <56 years (aHR 2.07), and persisted among those without baseline ischemic heartdisease or congestive heart failure (aHR 1.37). In sarcoidosis, baseline conduction disorders (aHR 4.88) and congestive heart failure (aHR 5.13) were the strongest independent predictors. Conclusions Sarcoidosis is associated with increased long-term risk of major cardiac electrical outcomes versus the general population, particularly among women and patients younger than 56 years.SurvivalRisks
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Murninkas et al. (2026) conducted a cohort in Sarcoidosis (n=10,492). Sarcoidosis vs. Matched general population controls was evaluated on Composite of cardiac implantable electronic device (CIED) implantation, sudden cardiac death, or cardiac arrest (aHR 1.40, 95% CI 1.12-1.75). Sarcoidosis was associated with an increased risk of CIED implantation, sudden cardiac death, or cardiac arrest vs matched controls (2.31 vs 1.93 per 1,000 person-years; aHR 1.40, 95% CI 1.12-1.75).
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