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Race Comparisons in Patients With Cardiac Sarcoidosis : Insights From the Cardiac Sarcoidosis Consortium

Trongtorsak, Angkawipa ; Martinez, De La Rosa ; Crawford, Thomas C. ; Bogun, Frank M. ; Gu, Xiaokui ; Puroll, Eric ; Ellenbogen, Kenneth A. ; Chicos, Alexandru B. ; Roukoz, Henri and Zimetbaum, Peter J. , et al. (2025) In Circulation: Arrhythmia and Electrophysiology 18(7). p.013670-013670
Abstract

BACKGROUND: Differences in cardiac sarcoidosis between racial groups remain understudied. Therefore, this study aims to explore race differences in patients with cardiac sarcoidosis. 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... (More)

BACKGROUND: Differences in cardiac sarcoidosis between racial groups remain understudied. Therefore, this study aims to explore race differences in patients with cardiac sarcoidosis. 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.

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type
Contribution to journal
publication status
published
subject
keywords
glucocorticoids, heart transplantation, race factors, smoking, ventricular fibrillation
in
Circulation: Arrhythmia and Electrophysiology
volume
18
issue
7
pages
013670 - 013670
publisher
Lippincott Williams & Wilkins
external identifiers
  • scopus:105009284430
  • pmid:40557494
ISSN
1941-3149
DOI
10.1161/CIRCEP.124.013670
language
English
LU publication?
yes
additional info
Publisher Copyright: © 2025 American Heart Association, Inc.
id
dee44891-5440-48ed-844e-871047a253ed
date added to LUP
2025-12-15 14:31:32
date last changed
2025-12-16 03:00:08
@article{dee44891-5440-48ed-844e-871047a253ed,
  abstract     = {{<p>BACKGROUND: Differences in cardiac sarcoidosis between racial groups remain understudied. Therefore, this study aims to explore race differences in patients with cardiac sarcoidosis. 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&lt;0.001), diabetes (37.8% versus 21.0%; P&lt;0.001), smoking (40.9% versus 26.8%; P&lt;0.001), chronic obstructive pulmonary disease or emphysema (15.5% versus 4.1%; P&lt;0.001), and chronic kidney disease (25.9% versus 12.4%; P&lt;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 &gt;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.</p>}},
  author       = {{Trongtorsak, Angkawipa and Martinez, De La Rosa and Crawford, Thomas C. and Bogun, Frank M. and Gu, Xiaokui and Puroll, Eric and Ellenbogen, Kenneth A. and Chicos, Alexandru B. and Roukoz, Henri and Zimetbaum, Peter J. and Kalbfleisch, Steven J. and Murgatroyd, Francis D. and Steckman, David A. and Rosenfeld, Lynda E. and Soejima, Kyoko and Bhan, Adarsh K. and Vedantham, Vasanth and Dickfeld, Timm Michael L. and Delurgio, David B. and Platonov, Pyotr G. and Zipse, Matthew M. and Nishiuchi, Suguru and Ortman, Matthew L. and Narasimhan, Calambur and Patton, Kristen K. and Rosenthal, David G. and Mukerji, Siddharth S. and Hoogendoorn, Jarieke C. and Zeppenfeld, Katja and Torosoff, Mikhail and Judson, Marc A. and Martin, Katherine and Madias, Christopher and Hermel, Melody and Nour, Khaled and Torbey, Estelle and Sauer, William H. and Kron, Jordana}},
  issn         = {{1941-3149}},
  keywords     = {{glucocorticoids; heart transplantation; race factors; smoking; ventricular fibrillation}},
  language     = {{eng}},
  month        = {{07}},
  number       = {{7}},
  pages        = {{013670--013670}},
  publisher    = {{Lippincott Williams & Wilkins}},
  series       = {{Circulation: Arrhythmia and Electrophysiology}},
  title        = {{Race Comparisons in Patients With Cardiac Sarcoidosis : Insights From the Cardiac Sarcoidosis Consortium}},
  url          = {{http://dx.doi.org/10.1161/CIRCEP.124.013670}},
  doi          = {{10.1161/CIRCEP.124.013670}},
  volume       = {{18}},
  year         = {{2025}},
}