We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Cardiac sarcoidosis: A long term follow up study.
- Authors
Cacoub, Patrice; Chapelon-Abric, Catherine; Resche-Rigon, Matthieu; Saadoun, David; Desbois, Anne Claire; Biard, Lucie
- Abstract
Background: Prognostic factors are lacking in cardiac sarcoidosis (CS), and the effects of immunosuppressive treatments are unclear. Objectives: To identify prognostic factors and to assess the effects of immunosuppressive drugs on relapse risk in patients presenting with CS. Methods: From a cohort of 157 patients with CS with a median follow-up of 7 years, we analysed all cardiac and extra-cardiac data and treatments, and assessed relapse-free and overall survival. Results: The 10-year survival rate was 90% (95% CI, 84–96). Baseline factors associated with mortality were the presence of high degree atrioventricular block (HR, 5.56, 95% CI 1.7–18.2, p = 0.005), left ventricular ejection fraction below 40% (HR, 4.88, 95% CI 1.26–18.9, p = 0.022), hypertension (HR, 4.79, 95% CI 1.06–21.7, p = 0.042), abnormal pulmonary function test (HR, 3.27, 95% CI 1.07–10.0, p = 0.038), areas of late gadolinium enhancement on cardiac magnetic resonance (HR, 2.26, 95% CI 0.25–20.4, p = 0.003), and older age (HR per 10 years 1.69, 95% CI 1.13–2.52, p = 0.01). The 10-year relapse-free survival rate for cardiac relapses was 53% (95% CI, 44–63). Baseline factors that were independently associated with cardiac relapse were kidney involvement (HR, 3.35, 95% CI 1.39–8.07, p = 0.007), wall motion abnormalities (HR, 2.30, 95% CI 1.22–4.32, p = 0.010), and left heart failure (HR 2.23, 95% CI 1.12–4.45, p = 0.023). After adjustment for cardiac involvement severity, treatment with intravenous cyclophosphamide was associated with a lower risk of cardiac relapse (HR 0.16, 95% CI 0.033–0.78, p = 0.024). Conclusions: Our study identifies putative factors affecting morbidity and mortality in cardiac sarcoidosis patients. Intravenous cyclophosphamide is associated with lower relapse rates.
- Subjects
LONGITUDINAL method; SARCOIDOSIS; VENTRICULAR ejection fraction; PULMONARY function tests; SUBSTANCE abuse relapse
- Publication
PLoS ONE, 2020, Vol 15, Issue 9, p1
- ISSN
1932-6203
- Publication type
Article
- DOI
10.1371/journal.pone.0238391