Effect of Corticosteroid Therapy on Long-Term Clinical Outcome and Left Ventricular Function in Patients With Cardiac Sarcoidosis

• Nagai Toshiyuki

  Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center

• Nagano Nobutaka

  Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center

• Sugano Yasuo

  Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center

• Asaumi Yasuhide

  Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center

• Aiba Takeshi

  Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center

• Kanzaki Hideaki

  Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center

• Kusano Kengo

  Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center

• Noguchi Teruo

  Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center

• Yasuda Satoshi

  Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center

• Ogawa Hisao

  Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University

• Anzai Toshihisa

  Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center

Abstract

Background:Cardiac involvement is the worst prognostic determinant in patients with sarcoidosis, but the long-term 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. (Circ J 2015; 79: 1593–1600)

Journal

• Circulation Journal

  Circulation Journal 79 (7), 1593-1600, 2015

  The Japanese Circulation Society

Keywords

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

Details

• CRID: 1390001205106936064
• NII Article ID: 130005083940
• NII Book ID: AA11591968
• DOI: 10.1253/circj.cj-14-1275
• ISSN: 13474820
• ISSN: 13469843
• NDL BIB ID: 026523744
• PubMed: 25877828
• Web Site: http://id.ndl.go.jp/bib/026523744
• Web Site: https://ndlsearch.ndl.go.jp/books/R000000004-I026523744
• Web Site: https://www.jstage.jst.go.jp/article/circj/79/7/79_CJ-14-1275/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2015335500
• Text Lang: en
• Data Source:
  • JaLC
  • NDL
  • Crossref
  • PubMed
  • CiNii Articles
  • KAKEN
• Abstract License Flag: Disallowed