Effect of corticosteroid therapy on long-term clinical outcome and left ventricular function in patients with cardiac sarcoidosis

Toshiyuki Nagai, Nobutaka Nagano, Yasuo Sugano, Yasuhide Asaumi, Takeshi Aiba, Hideaki Kanzaki, Kengo Kusano, Teruo Noguchi, Satoshi Yasuda, Hisao Ogawa, Toshihisa Anzai

Research output: Contribution to journalArticlepeer-review

39 Citations (Scopus)

Abstract

Background: Cardiac involvement is the worst prognostic determinant in patients with sarcoidosis, but the longterm prognostic significance of corticosteroid therapy for cardiac sarcoidosis (CS) remains unclear. Methods and Results: We examined 83 consecutive patients diagnosed with CS. Patients were divided into 2 groups based on the presence or absence of corticosteroid therapy at diagnosis. Patients with corticosteroid therapy had lower age and higher rate of positive findings in the myocardium on gallium scintigraphy (Ga) at diagnosis than those without. LVEF, biomarkers, and use of cardiovascular medication were similar between the 2 groups. During the follow-up (7.6±4.4 years), corticosteroid therapy was associated with fewer long-term adverse events (overall, P=0.005; cardiac death, P=0.92; symptomatic arrhythmias, P=0.89; heart failure admission, P<0.0001) and a greater % increase in LVEF than those without (7.9±36.3% vs. –16.7±34.8%, P=0.03). On Cox proportional hazards modeling, corticosteroid therapy (HR, 0.41; 95% CI: 0.20–0.89) was an independent determinant of long-term adverse event-free survival, but age, sex, LVEF, and Ga findings were not. Conclusions: Corticosteroid therapy might have a beneficial effect on long-term clinical outcome in CS patients, particularly by reduction of heart failure admission and retarding the progression of LV systolic dysfunction.

Original languageEnglish
Pages (from-to)1593-1600
Number of pages8
JournalCirculation Journal
Volume79
Issue number7
DOIs
Publication statusPublished - 2015 Jun 9
Externally publishedYes

Keywords

  • Cardiac sarcoidosis
  • Corticosteroid
  • Left ventricular function
  • Long-term prognosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'Effect of corticosteroid therapy on long-term clinical outcome and left ventricular function in patients with cardiac sarcoidosis'. Together they form a unique fingerprint.

Cite this