Abstract

Sarcoidosis is a chronic granulomatous disorder with multiorgan involvement. Cardiac sarcoidosis is characterized by the growth of granulomas in any part of the heart which portends a poor prognosis. These granulomas can cause conduction abnormalities. However, less is known about the in-hospital outcomes in patients with sarcoidosis who have concurrent arrhythmias. We aimed to identify whether arrhythmia impacted these outcomes. Objective was to study the impact of arrhtymias on in-hospital outcomes in patients with sarcoidosis. We queried the National Inpatient Sample (NIS) database of 2018- 2020. Adults admitted with a primary or secondary diagnosis of sarcoidosis were included. This population was stratified into those with and without arrhythmia {atrial fibrillation [AF], atrial flutters, SVTs, heart blocks [first, second degree, complete heart blocks (CHB)], ventricular tachycardia [VT] and fibrillation [VF]}. Demographics and association with other comorbidities was studied. Multivariate regression analysis was performed to identify the impact of arrhythmias taking mortality as primary outcome and total hospital cost as secondary. A total of 383385 hospitalised patients had sarcoidosis. Of those, 85205 (22.22%) had arrhythmias. Mean age was 59 years and 54.03% were females. Traditional cardiac risk factors like diabetes mellitus (39.79% vs 37.61%, p<0.05),and hyperlipidemia (48.39% vs 38.79%, p<0.01) were more prevalent in the cohort of sarcoid patients with arrhythmias. The prevalence of valvular abnormalities(25.12% vs 16.85%,p<0.01), CAD (33.32% vs 17.72%, p<0.01) and old myocardial infarction (8.9% vs 5.32%, p<0.01) was also significantly higher in these patients. After adjusting for covariates, the odds of mortality was higher with VF, VT, CHB and AF in adult patients with sarcoidosis (table 1). The total hospital charge was also considerably more in sarcoid patients with concomitant VF, VT, CHB and AF (table 1). This study concludes that patients with sarcoidosis have a higher prevalence of risk factors like diabetes and hyperlipidemia and also how the presence of underlying arrhythmias leads to significantly worse outcomes in terms of mortality and in-hospital cost. These findings necessitate the need for further research to understand the pathophysiology of arrhythmias in Sarcoidosis cohort. This will further help in guiding therapeutic interventions to prevent the burden of arrhythmias in patients with sarcoidosis to improve patient outcomes.

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