Corticosteroid therapy in patients with cardiac sarcoidosis was associated with improved long-term adverse event-free survival (HR 0.41; 95% CI 0.20-0.89) and a greater increase in LVEF.
Cohort (n=83)
Does corticosteroid therapy improve long-term clinical outcomes and left ventricular function in patients with cardiac sarcoidosis?
Corticosteroid therapy in cardiac sarcoidosis is associated with improved long-term adverse event-free survival, primarily by reducing heart failure admissions and preserving left ventricular systolic function.
Effect estimate: HR 0.41 (95% CI 0.20-0.89)
p-value: p=0.005
BACKGROUND: Cardiac involvement is the worst prognostic determinant in patients with sarcoidosis, but the long-term prognostic significance of corticosteroid therapy for cardiac sarcoidosis (CS) remains unclear. METHODS AND RESULTS: We examined 83 consecutive patients diagnosed with CS. Patients were divided into 2 groups based on the presence or absence of corticosteroid therapy at diagnosis. Patients with corticosteroid therapy had lower age and higher rate of positive findings in the myocardium on gallium scintigraphy (Ga) at diagnosis than those without. LVEF, biomarkers, and use of cardiovascular medication were similar between the 2 groups. During the follow-up (7.6±4.4 years), corticosteroid therapy was associated with fewer long-term adverse events (overall, P=0.005; cardiac death, P=0.92; symptomatic arrhythmias, P=0.89; heart failure admission, P<0.0001) and a greater % increase in LVEF than those without (7.9±36.3% vs. -16.7±34.8%, P=0.03). On Cox proportional hazards modeling, corticosteroid therapy (HR, 0.41; 95% CI: 0.20-0.89) was an independent determinant of long-term adverse event-free survival, but age, sex, LVEF, and Ga findings were not. CONCLUSIONS: Corticosteroid therapy might have a beneficial effect on long-term clinical outcome in CS patients, particularly by reduction of heart failure admission and retarding the progression of LV systolic dysfunction.
Nagai et al. (Thu,) conducted a cohort in Cardiac sarcoidosis (n=83). Corticosteroid therapy vs. No corticosteroid therapy was evaluated on Long-term adverse event-free survival (HR 0.41, 95% CI 0.20-0.89, p=0.005). Corticosteroid therapy in patients with cardiac sarcoidosis was associated with improved long-term adverse event-free survival (HR 0.41; 95% CI 0.20-0.89) and a greater increase in LVEF.