Race Comparisons in Patients With Cardiac Sarcoidosis: Insights From the Cardiac Sarcoidosis Consortium.
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Trongtorsak Angkawipa, De La Rosa Martinez Junior, Crawford Thomas C, Bogun Frank M, Gu Xiaokui, Puroll Eric, Ellenbogen Kenneth A, Chicos Alexandru B, Roukoz Henri, Zimetbaum Peter J, Kalbfleisch Steven J, Murgatroyd Francis D, Steckman David A, Rosenfeld Lynda E, Soejima Kyoko, Bhan Adarsh K, Vedantham Vasanth, Dickfeld Timm-Michael L, DeLurgio David B, Platonov Pyotr G, Zipse Matthew M, Nishiuchi Suguru, Ortman Matthew L, Narasimhan Calambur, Patton Kristen K, Rosenthal David G, Mukerji Siddharth S, Hoogendoorn Jarieke C, Zeppenfeld Katja, Torosoff Mikhail, Judson Marc A, Martin Katherine, Madias Christopher, Hermel Melody, Nour Khaled, Torbey Estelle, Sauer William H, Kron Jordana, Cardiac Sarcoidosis Consortium
Аннотация
METHODS: We analyzed data from the Cardiac Sarcoidosis Consortium, an international registry including over 25 centers. The primary clinical outcome was a composite end point of all-cause mortality, left ventricular assist device implantation, heart transplantation, or implantable cardioverter defibrillator therapy.
RESULTS: A total of 619 patients were included in the study (362 White, 193 Black, and 64 other races). Black patients were diagnosed with cardiac sarcoidosis at a younger age (50.5±11.8 versus 53.7±10.5 years old; P=0.010) compared with White patients. Left ventricular ejection fraction was significantly lower in Black patients (44.6±15.4 versus 48.3±14.0; P=0.008). In addition, extracardiac involvement in the lungs (80.3% versus 72.7%; P=0.046), skin (22.8% versus 12.4%; p=0.002), and eyes (13.5% versus 5.5%; P=0.001) was more prevalent in Black patients. Patients had significantly higher rates of hypertension (69.9% versus 50.6%; P<0.001), diabetes (37.8% versus 21.0%; P<0.001), smoking (40.9% versus 26.8%; P<0.001), chronic obstructive pulmonary disease or emphysema (15.5% versus 4.1%; P<0.001), and chronic kidney disease (25.9% versus 12.4%; P<0.001). The treatment patterns including glucocorticoid (71% versus 74.3%; P=0.4), glucocorticoid-sparing (53.4% versus 59.9%; P=0.14), and implantable cardioverter defibrillator or cardiac resynchronization implantation (75.6% versus 73.8%; P=0.63), were similar. No significant differences were found in the primary outcome (29.5% in Black versus 28.5% in White; P=0.79). Subgroup analysis of the primary outcome also revealed no significant differences in both the left ventricular ejection fraction >35% group (24.1% in Black versus 25.9% in White; P=0.72) and the left ventricular ejection fraction ≤35% group (51% versus 42.5%; P=0.35).
CONCLUSIONS: Black patients with cardiac sarcoidosis exhibited significantly higher rates of lung, skin, and eye involvement and comorbidities, but had similar cardiac clinical outcomes and all-cause mortality compared with White patients. Nonetheless, ascertainment bias cannot be excluded.