Heart Failure, Atrioventricular Block, and Ventricular Tachycardia in Sarcoidosis
Background Sarcoidosis is a granulomatous disease usually affecting the lungs, although cardiac morbidity may be common. The risk of these outcomes and the characteristics that predict them remain largely unknown. This study investigates the epidemiology of heart failure, atrioventricular block, and...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2021-03-01
|
| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.120.017692 |
| _version_ | 1811332360737652736 |
|---|---|
| author | David G. Rosenthal Christina D. Fang Christopher A. Groh Gregory Nah Eric Vittinghoff Thomas A. Dewland Vasanth Vedantham Gregory M. Marcus |
| author_facet | David G. Rosenthal Christina D. Fang Christopher A. Groh Gregory Nah Eric Vittinghoff Thomas A. Dewland Vasanth Vedantham Gregory M. Marcus |
| author_sort | David G. Rosenthal |
| collection | DOAJ |
| description | Background Sarcoidosis is a granulomatous disease usually affecting the lungs, although cardiac morbidity may be common. The risk of these outcomes and the characteristics that predict them remain largely unknown. This study investigates the epidemiology of heart failure, atrioventricular block, and ventricular tachycardia among patients with and without sarcoidosis. Methods and Results We identified California residents aged ≥21 years using the Office of Statewide Health Planning and Development ambulatory surgery, emergency, or inpatient databases from 2005 to 2015. The risk of sarcoidosis on incident heart failure, atrioventricular block, and ventricular tachycardia were each determined. Linkage to the Social Security Death Index was used to ascertain overall mortality. Among 22 527 964 California residents, 19 762 patients with sarcoidosis (0.09%) were identified. Sarcoidosis was the strongest predictor of heart failure (hazard ratio [HR], 11.2; 95% CI, 10.7–11.7), atrioventricular block (HR, 117.7; 95% CI, 103.3–134.0), and ventricular tachycardia (HR, 26.1; 95% CI, 24.2–28.1) identified among all risk factors. The presence of any cardiac involvement best predicted each outcome. Approximately 22% (95% CI, 18%–26%) of the relationship between sarcoidosis and increased mortality was explained by the presence of at least 1 of these cardiovascular outcomes. Conclusions The magnitude of risk associated with sarcoidosis as a predictor of heart failure, atrioventricular block, and ventricular tachycardia, exceeds all established risk factors. Surveillance for and anticipation of these outcomes among patients with sarcoidosis is indicated, and consideration of a sarcoidosis diagnosis may be prudent among patients with heart failure, atrioventricular block, or ventricular tachycardia. |
| first_indexed | 2024-04-13T16:35:39Z |
| format | Article |
| id | doaj.art-dcee726ac9bd4e978699a81c78188398 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-13T16:35:39Z |
| publishDate | 2021-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-dcee726ac9bd4e978699a81c781883982022-12-22T02:39:27ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802021-03-0110510.1161/JAHA.120.017692Heart Failure, Atrioventricular Block, and Ventricular Tachycardia in SarcoidosisDavid G. Rosenthal0Christina D. Fang1Christopher A. Groh2Gregory Nah3Eric Vittinghoff4Thomas A. Dewland5Vasanth Vedantham6Gregory M. Marcus7Division of Cardiology, Electrophysiology Section University of California, San Francisco CADivision of Cardiology, Electrophysiology Section University of California, San Francisco CADivision of Cardiology, Electrophysiology Section University of California, San Francisco CADivision of Cardiology, Electrophysiology Section University of California, San Francisco CADepartment of Epidemiology and Biostatistics University of California, San Francisco CADivision of Cardiology, Electrophysiology Section University of California, San Francisco CADivision of Cardiology, Electrophysiology Section University of California, San Francisco CADivision of Cardiology, Electrophysiology Section University of California, San Francisco CABackground Sarcoidosis is a granulomatous disease usually affecting the lungs, although cardiac morbidity may be common. The risk of these outcomes and the characteristics that predict them remain largely unknown. This study investigates the epidemiology of heart failure, atrioventricular block, and ventricular tachycardia among patients with and without sarcoidosis. Methods and Results We identified California residents aged ≥21 years using the Office of Statewide Health Planning and Development ambulatory surgery, emergency, or inpatient databases from 2005 to 2015. The risk of sarcoidosis on incident heart failure, atrioventricular block, and ventricular tachycardia were each determined. Linkage to the Social Security Death Index was used to ascertain overall mortality. Among 22 527 964 California residents, 19 762 patients with sarcoidosis (0.09%) were identified. Sarcoidosis was the strongest predictor of heart failure (hazard ratio [HR], 11.2; 95% CI, 10.7–11.7), atrioventricular block (HR, 117.7; 95% CI, 103.3–134.0), and ventricular tachycardia (HR, 26.1; 95% CI, 24.2–28.1) identified among all risk factors. The presence of any cardiac involvement best predicted each outcome. Approximately 22% (95% CI, 18%–26%) of the relationship between sarcoidosis and increased mortality was explained by the presence of at least 1 of these cardiovascular outcomes. Conclusions The magnitude of risk associated with sarcoidosis as a predictor of heart failure, atrioventricular block, and ventricular tachycardia, exceeds all established risk factors. Surveillance for and anticipation of these outcomes among patients with sarcoidosis is indicated, and consideration of a sarcoidosis diagnosis may be prudent among patients with heart failure, atrioventricular block, or ventricular tachycardia.https://www.ahajournals.org/doi/10.1161/JAHA.120.017692atrioventricular blockcardiac sarcoidosiscardiomyopathysarcoidosisventricular tachycardia |
| spellingShingle | David G. Rosenthal Christina D. Fang Christopher A. Groh Gregory Nah Eric Vittinghoff Thomas A. Dewland Vasanth Vedantham Gregory M. Marcus Heart Failure, Atrioventricular Block, and Ventricular Tachycardia in Sarcoidosis Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease atrioventricular block cardiac sarcoidosis cardiomyopathy sarcoidosis ventricular tachycardia |
| title | Heart Failure, Atrioventricular Block, and Ventricular Tachycardia in Sarcoidosis |
| title_full | Heart Failure, Atrioventricular Block, and Ventricular Tachycardia in Sarcoidosis |
| title_fullStr | Heart Failure, Atrioventricular Block, and Ventricular Tachycardia in Sarcoidosis |
| title_full_unstemmed | Heart Failure, Atrioventricular Block, and Ventricular Tachycardia in Sarcoidosis |
| title_short | Heart Failure, Atrioventricular Block, and Ventricular Tachycardia in Sarcoidosis |
| title_sort | heart failure atrioventricular block and ventricular tachycardia in sarcoidosis |
| topic | atrioventricular block cardiac sarcoidosis cardiomyopathy sarcoidosis ventricular tachycardia |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.120.017692 |
| work_keys_str_mv | AT davidgrosenthal heartfailureatrioventricularblockandventriculartachycardiainsarcoidosis AT christinadfang heartfailureatrioventricularblockandventriculartachycardiainsarcoidosis AT christopheragroh heartfailureatrioventricularblockandventriculartachycardiainsarcoidosis AT gregorynah heartfailureatrioventricularblockandventriculartachycardiainsarcoidosis AT ericvittinghoff heartfailureatrioventricularblockandventriculartachycardiainsarcoidosis AT thomasadewland heartfailureatrioventricularblockandventriculartachycardiainsarcoidosis AT vasanthvedantham heartfailureatrioventricularblockandventriculartachycardiainsarcoidosis AT gregorymmarcus heartfailureatrioventricularblockandventriculartachycardiainsarcoidosis |