Abstract 13629: Increased Rate of High Risk Cardiac Outcomes in Patients With Cardiac Sarcoidosis Without Underlying Coronary Artery Disease: Analysis of the National Inpatient Sample From 2015-2019

Abstract

Introduction: Sarcoidosis is a systemic disease characterized by deposition of noncaseating granulomas. It commonly involves the lungs but can also affect other organs such as the heart. In terms of cardiac sarcoidosis, it is still a relatively under diagnosed illness with its clinical manifestations often being variable and nonspecific thus making the diagnosis challenging. There is a need to further investigate the burden of high-risk cardiac outcomes in patients with underlying sarcoidosis with cardiac involvement to further understand the extent of disease progression in this group. Methods: In this study, the National Inpatient Sample (NIS) was queried for the years 2015 Q4-2019. Our cohort of interest included patients with Sarcoidosis, more specifically, those with cardiac involvement. Patients with underlying coronary artery disease and its equivalents were excluded from the study. Multivariate logistic with linear regression analysis was used to adjust for confounders. Results: After excluding patients with coronary artery disease (CAD) equivalents, the final number of patients included in the study was 8,722,809. Out of which, 54,537 had sarcoidosis with a total of 918 having a diagnosis of cardiac sarcoidosis (CS). Patients with CS were more likely to be males and be younger than 65 (p<0.001). African American race was the predominant population affected in both cohorts (p<0.001). The CS group had higher rates of underlying congestive heart failure but were overall less likely to have underlying connective tissue disease, chronic pulmonary disease, and diabetes (p<0.001). In terms of cardiac outcomes, they had higher rates of Cardiac Arrest (2.2% vs 0.7%, p<0.001), Atrial Fibrillation (24.5% vs 10.4%, p<0.001), Ventricular Tachycardia (36.6% vs 2.0%, p<0.001), AV Block Type 3 (10.3% vs 0.7%, p<0.001) and Heart Failure [systolic HF (54.6% vs 6.6%, p<0.001), diastolic HF (20.9% vs 12.3%, p<0.001)]. Conclusions: We demonstrate with the results of this study that patients with cardiac sarcoidosis had higher rates of major arrhythmias, conduction defects, and cardiac arrest. Understanding these associations may help in earlier clinical diagnosis and possibly improved outcomes with targeted therapies.