Prevalence of cardiovascular complications and factors associated with higher case-fatality rate among hospitalized patients with sarcoidosis

Abstract Background Cardiovascular (CV) involvement is a serious complication of sarcoidosis with exaggerated morbidity and mortality. However, the prevalence of CV comorbidities and their case-fatality rate have not been established among hospitalized patients with sarcoidosis. Methods Using the National Inpatient Sample (NIS) database, hospitalized patients with a diagnosis of sarcoidosis were identified. The prevalence of each CV comorbidity and the associated case-fatality rate was determined among this population of patients. Results Data of 406,315 admission cases with a diagnosis of sarcoidosis was analyzed from 2016 to 2020. Of this, 13,950 patients (3.4%) had AMI (STEMI: 0.3% and NSTEMI: 2.3%), 121,515 patients (30%) had HF (HFrEF: 8% and HFpEF: 13%), 7,470 patients (1.8%) had CVA, 8,825 patients had sarcoid myocarditis (2.2%), 8,965 patients (5.6%) had PVD, 71,815 patients had Afib (17.7%), 46,775 patients (11.5%) had cardiorenal syndrome, and 3,905 patients (1%) developed cardiac arrest. Case-Fatality rate was the highest for sarcoidosis patients who developed cardiac arrest (61.4%), followed by STEMI (11.6%), NSTEMI (7.7%), and cardiac tamponade (7.8%). Increasing age (2% for each year), male gender (14% more than females), and black race (25%) but not economic status was associated with increased odds of death among patients with sarcoidosis. While PCI was associated with a lower mortality rate (aOR: 0.4, 95%CI:0.2-0.7, P=0.005), revascularization with CABG (aOR: 0.3, 95% CI: 0.1-1.2, P=0.08) did not reduce the mortality rate. Conclusion Atrial fibrillation, heart failure (HFpEF > HFrEF), and cardiorenal syndrome are the most common cardiovascular complications among hospitalized patents with sarcoidosis. However, case-fatality rate is significantly higher for other less prevalent cardiovascular comorbidities of sarcoidosis, which include cardiac arrest, acute myocardial infarction (STEMI > NSTEMI), and cardiac tamponade.