Characteristics and outcomes of hospitalized patients with Isolated and systemic cardiac sarcoidosis: analysis of the Nationwide readmissions database 2016–2021
File(s)
Published version
Author(s)
Type
Journal Article
Abstract
Objective:
To identify any differences in the characteristics and outcomes of patients with Isolated cardiac sarcoidosis (iCS) vs systemic cardiac sarcoidosis (sCS).
Patients and methods:
All inpatient encounters in the Nationwide Readmission Database from 2016 to 2021 were analyzed for the rates, predictors, costs and mortality during index and unplanned 90-days readmissions for iCS and sCS patients. Patients with ischemic heart disease were excluded.
Results:
1,667 patients were identified (57.8 % male), of which, 1,013 (60.8 %) had iCS and 654 (39.2 %) had sCS. The median (IQR) age of iCS patients was slightly older [57.0 (49.0–66.0) vs 56.0 (48.0–64.0), p = 0.04]. On index admission, iCS patients had higher prevalence of ventricular tachycardia (36.9 % vs 28.8 %, p = 0.001) and catheter ablation (5.6 % vs 2.8 %, p = 0.006). The predictors for all-cause readmissions were Charlson Comorbidity Index (CCI) (HR 1.19, 95 % CI 1.01–1.40, p = 0.04), age (HR 0.98 (0.97–1.00), p = 0.01) and the use of anticoagulant therapy (HR 1.92, 95 % CI 1.35–2.72, p < 0.001). Patients with sCS were more likely to be readmitted with heart failure compared to iCS patients (SHR 3.78, 95 % CI 1.11–12.94, p = 0.03). During subsequent readmission, iCS and sCS patients had comparable rates of in-hospital mortality, median length of stay and healthcare-associated costs. No independent predictors of in-hospital mortality at readmission were ascertained.
Conclusions:
Isolated CS patients, when compared to systemic CS, had a greater prevalence of ventricular tachycardia and catheter ablation. They were less likely to be re-hospitalized with heart failure within 90-days. Age, higher CCI, and use of anticoagulant therapy were predictors for all-cause readmissions.
To identify any differences in the characteristics and outcomes of patients with Isolated cardiac sarcoidosis (iCS) vs systemic cardiac sarcoidosis (sCS).
Patients and methods:
All inpatient encounters in the Nationwide Readmission Database from 2016 to 2021 were analyzed for the rates, predictors, costs and mortality during index and unplanned 90-days readmissions for iCS and sCS patients. Patients with ischemic heart disease were excluded.
Results:
1,667 patients were identified (57.8 % male), of which, 1,013 (60.8 %) had iCS and 654 (39.2 %) had sCS. The median (IQR) age of iCS patients was slightly older [57.0 (49.0–66.0) vs 56.0 (48.0–64.0), p = 0.04]. On index admission, iCS patients had higher prevalence of ventricular tachycardia (36.9 % vs 28.8 %, p = 0.001) and catheter ablation (5.6 % vs 2.8 %, p = 0.006). The predictors for all-cause readmissions were Charlson Comorbidity Index (CCI) (HR 1.19, 95 % CI 1.01–1.40, p = 0.04), age (HR 0.98 (0.97–1.00), p = 0.01) and the use of anticoagulant therapy (HR 1.92, 95 % CI 1.35–2.72, p < 0.001). Patients with sCS were more likely to be readmitted with heart failure compared to iCS patients (SHR 3.78, 95 % CI 1.11–12.94, p = 0.03). During subsequent readmission, iCS and sCS patients had comparable rates of in-hospital mortality, median length of stay and healthcare-associated costs. No independent predictors of in-hospital mortality at readmission were ascertained.
Conclusions:
Isolated CS patients, when compared to systemic CS, had a greater prevalence of ventricular tachycardia and catheter ablation. They were less likely to be re-hospitalized with heart failure within 90-days. Age, higher CCI, and use of anticoagulant therapy were predictors for all-cause readmissions.
Date Issued
2025-04-01
Date Acceptance
2025-02-18
Citation
International Journal of Cardiology: Heart & Vasculature, 2025, 57
ISSN
2352-9067
Publisher
Elsevier
Journal / Book Title
International Journal of Cardiology: Heart & Vasculature
Volume
57
Copyright Statement
© 2025 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
License URL
Identifier
10.1016/j.ijcha.2025.101636
Subjects
Isolated cardiac sarcoidosis Systemic sarcoidosis National Readmissions Database AF, Atrial Fibrillation
AFL, Atrial Flutter
AVB, Atrioventricular Block
BNP, Brain Natriuretic Peptide
CABG, Coronary Artery Bypass Grafting
CAD, Coronary Artery Disease
CHF, Chronic Heart Failure
CI, Confidence Interval
CLD, Chronic Liver Disease
CPD, Chronic Pulmonary Disease
CKD, Chronic Kidney Disease
CRT-D, Cardiac Resynchronization Therapy with Defibrillator
CRT-P, Cardiac Resynchronization Therapy with Pacemaker
CVD, Cerebrovascular Disease
DOAC, Direct Oral Anticoagulant
HAC, Healthcare-Associated Cost
HCUP, Healthcare Utilization Project
HF, Heart Failure
HR, Hazard Ratio
HTN, Hypertension
ICD, Implantable Cardioverter Defibrillator
ICD-10-CM, International Classification of Diseases, Tenth Edition, Clinical Modification
IQR, Interquartile Range
K-M curve, Kaplan-Meier (curve)
LOS, Length of Stay
LV, Left Ventricle
MACE, Major Adverse Cardiac Events
MI, Myocardial Infarction/Ischemia
NRD, National Readmission Database
NSTEMI, Non-ST elevation Myocardial Infarction
NT-pro-BNP, N-terminal pro B-type Natriuretic Peptide
OR, Odds Ratio
PE,
Publication Status
Published
Article Number
ARTN 101636
Date Publish Online
2024-02-24