Association between sarcoidosis and cardiovascular Outcomes: A systematic review and Meta-analysis

Vikash Jaiswal; Song Peng Ang; Zouina Sarfraz; Swatika Butey; Harshwardhan Vinod Khandait; David Song; Jia Ee Chia; Dipansha Maroo; Muhammad Hanif; Mohammed Ghanim; Raja Chand; Monodeep Biswas

doi:10.1016/j.ijcha.2022.101073

Association between sarcoidosis and cardiovascular Outcomes: A systematic review and Meta-analysis

Int J Cardiol Heart Vasc. 2022 Jun 29:41:101073. doi: 10.1016/j.ijcha.2022.101073. eCollection 2022 Aug.

Authors

Affiliations

¹ AMA School Of Medicine, Makati, Philippines.
² Department of Internal Medicine, Rutgers Health/Community Medical Center, NJ, USA.
³ Fatima Jinnah Medical University, Lahore, Pakistan.
⁴ Indira Gandhi Government Medical College, Nagpur, India.
⁵ Department of Internal Medicine, Trinitas Regional Medical Center, Elizabeth, NJ, USA.
⁶ Department of Internal Medicine, Icahn School of Medicine at Mount Sinai Hospital, NY, USA.
⁷ School of Medicine, International Medical University, Kuala Lumpur, Malaysia.
⁸ Maulana Azad Medical College, New Delhi, India.
⁹ Department of Internal Medicine, Suny Upstate Medical University, NY, USA.
¹⁰ Henry Ford Healthcare System, Detroit, MI, USA.
¹¹ General Cardiology and Advanced Heart Failure, Wellspan Cardiology, Lancaster, PA, USA.

Abstract

Background: Sarcoidosis is a chronic inflammatory disorder of unknown etiology associated with high morbidity and mortality. Its association with cardiovascular outcomes is under-documented.

Aim: The aim of this study was to assess the adverse cardiovascular outcomes in patients with sarcoidosis compared with that of non-sarcoidosis.

Methodology: Online databases including PubMed, Embase and Scopus were queried from inception until March 2022. The outcomes assessed included all-cause mortality (ACM) and incidence of ventricular tachycardia (VT), heart failure (HF) and atrial arrhythmias (AA).

Result: A total of 6 studies with 22,539,096 participants (42,763 Sarcoidosis, 22,496,354 Non-Sarcoidosis) were included in this analysis. The pooled prevalence of sarcoidosis was 13.1% (95% CI 1% to 70%). The overall mean age was 47 years. The most common comorbidities were hypertension (12.7% vs 12.5%), and diabetes mellitus (5.5% vs 4%) respectively. The pooled analysis of primary endpoints showed that all-cause mortality (RR, 2.08; 95% CI: 1.17 to 3.08; p = 0.01) was significantly increased in sarcoidosis patients. The pooled analysis of secondary endpoints showed that the incidence of VT (RR, 15.3; 95% CI: 5.39 to 43.42); p < 0.001), HF (RR, 4.96; 95% CI: 2.02 to 12.14; p < 0.001) and AA (RR, 2.55; 95% CI: 1.47 to 4.44); p = 0.01) were significantly higher with sarcoidosis respectively compared to non-sarcoidosis.

Conclusion: Incidence of VT, HF and AA was significantly higher in patients with CS. Clinicians should be aware of these adverse cardiovascular events associated with sarcoidosis.

Keywords: AA, Atrial Arrhythmia; ACM, All-cause mortality; ACS, Acute coronary syndrome; Atrial Arrhythmia; CS, Cardiac Sarcoidosis; Cardiovascular outcomes; HF, Heart failure; Heart Failure; ICD, Implantable Cardioverter Defibrillator; MI, Myocardial infarction; Mortality; NA, Not available; NS, Non-Sarcoidosis; OR, Odds ratio; Pathology; RCT, Randomized Controlled Trial; Sarcoidosis; VT, Ventricular Tachycardia; Ventricular Arrhythmia.

Publication types

Retracted Publication