The long-term prognostic significance of heart failure in sarcoidosis patients ─ a cohort study

ABSTRACT

Objective

To evaluate the proportion and the long-term prognostic significance of heart failure (HF) in sarcoidosis patients.

Methods

Data extracted from a large Israeli healthcare provider’s database were used to study sarcoidosis patients and matched non-sarcoidosis controls since 2000 to 2016. The proportion of HF was compared between the groups, and the associations between sarcoidosis, HF, and all-cause mortality were assessed.

Results

Included were 3,993 sarcoidosis patients and 19,856 age- and sex-matched controls. The proportion of HF patients was higher among the former (10.9% and 5.3%, respectively). A logistic regression model for multivariable analysis for covariates found sarcoidosis to be independently associated with HF (Odds Ratio (OR) 2.09 confidence interval (CI) 1.83–2.39). A total of 710 sarcoidosis patients (17.8%) and 2,121 controls (10.7%) died during the study period (p < 0.001). A multivariable survival analysis found an estimated hazard ratio (HR) of 1.84 (95%CI 1.67–2.02), indicating a significant association between sarcoidosis and risk for all-cause mortality. Our analysis also revealed a significant association between HF and risk for all-cause mortality (HR 3.05, 95%CI 2.77–3.36).

Conclusions

Sarcoidosis is independently associated with HF, and both are independently associated with all-cause mortality.

KEYWORDS:

• Sarcoidosis
• heart failure
• prognosis
• cohort
• autoimmunity

Acknowledgments

None stated

Availability of data and material

The data used during the current study are not available according to ethical privacy protection principals. The code used during the current study is available from the corresponding author.

Ethical approval

This study was approved by the ethical committee of Clalit Health Services.

Declaration of financial/other relationships

Arnon D. Cohen - Received research grants from Janssen, Novartis, AbbVie, Janssen and Sanofi. Also served as a consultant, advisor or speaker to AbbVie, Amgen, Boehringer Ingelheim, Dexcel Pharma, Janssen, Kamedis, Eli Lilly, Neopharm, Novartis, Perrigo, Pfizer, Rafa, Samsung Bioepis, Sanofi, Sirbal, and Taro.

All other authors have no relevant financial/other disclosures.

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Declaration of interest

No potential conflict of interest was reported by the authors.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors