Abstract 11490: Effect of Corticosteroid Therapy on Long-Term Prognosis in Patients With Cardiac Sarcoidosis
Backgrounds: Cardiac involvement is the worst prognostic determinant in patients with sarcoidosis, however, the long-term prognostic significance of corticosteroid therapy for cardiac sarcoidosis (CS) remains unclear.
Methods: We examined 77 consecutive patients who were initially diagnosed as CS by revised Japanese Ministry of Health and Welfare criteria. Patients were divided into two groups based on the presence or absence of corticosteroid therapy at initial diagnosis.
Results: Corticosteroid therapy was performed in 61 patients. Patients with corticosteroid therapy had lower age and higher incidence of positive findings in gallium scintigram (Ga) at initial diagnosis than those without. Left ventricular ejection fraction (LVEF), serum angiotensin converting enzyme (ACE) activity, lysozyme and brain natriuretic peptide (BNP) levels were comparable between two groups. During the follow-up (7.9±5.5 years), corticosteroid therapy was associated with lower long-term adverse events including all cause death, symptomatic arrhythmias, and heart failure admission (Figure 1). Cox proportional hazards modeling showed that corticosteroid therapy (HR 0.43, 95% CI 0.21-0.95) was independently associated with lower long-term adverse events among variables including age, gender, LVEF, ACE activity, lysozyme and BNP levels, and Ga findings. In subgroup analyses, corticosteroid therapy was associated with better clinical outcome among patients with higher age, lower ACE activity, and lower lysozyme level (Figure 2).
Conclusions: Starting corticosteroid therapy at initial diagnosis might be essential for better long-term clinical outcome in patients with CS.
- © 2013 by American Heart Association, Inc.