Abstract Body: Introduction:
Systemic hypertension (HTN) is prevalent in cardiac sarcoidosis (CS) and may influence long-term outcomes, particularly in patients receiving corticosteroids and calcineurin inhibitors. These treatments can increase susceptibility to elevated blood pressure and HTN crises, further complicating the management of CS.
Hypothesis:
This study compares long-term cardiovascular (CV) outcomes in patients with CS who have HTN versus those without HTN.
Methods:
This retrospective cohort study utilized the TriNetX Global Collaborative Network. Adult patients (≥18 years) diagnosed with both CS and HTN (January 2007 to May 2025) were included. Cohort 1 consisted of patients with both CS and HTN, while cohort 2 comprised a matched comparison group of CS without HTN. After propensity score matching, the mean age at diagnosis was 57 years (56% male, 41% female). Outcomes included all-cause mortality, HF, acute myocardial infarction (AMI), AF, and ventricular arrhythmias (VT/VF). Risk ratios (RR), hazard ratios (HR), 95% confidence intervals (CI), and p-values were calculated using TrinetX platform.
Results:
The risk of all-cause mortality was higher in cohort 1 (8.67%) vs cohort 2 (6.92%), with a RR of 1.253 (95% CI: 1.03–1.524), p = 0.0237. However, the HR was 1.06 (95% CI: 0.864–1.301), indicating no statistically significant difference in time-to-death between the cohorts. HF occurred in 57.47% of Cohort 1 vs. 44.45% in Cohort 2, RR 1.293 (95% CI: 1.222–1.368), HR 1.314 (95% CI: 1.213–1.424), p < 0.0001. The risk of AMI was significantly higher in Cohort 1 (8.01%) than Cohort 2 (3.71%), RR 2.157 (95% CI: 1.689–2.756), HR 1.927 (95% CI: 1.498–2.479), p < 0.0001. AF/flutter occurred in 31.61% of Cohort 1 vs. 21.23% of Cohort 2, RR 1.489 (95% CI: 1.352–1.641), HR 1.422 (95% CI: 1.271–1.591), p < 0.0001. Ventricular arrhythmias (VT/VF) were more frequent in Cohort 1 (34.65%) vs. Cohort 2 (30.65%), RR 1.131 (95% CI: 1.042–1.227), HR 1.036 (95% CI: 0.938–1.145), p = 0.0031.
Conclusion:
Patients with CS and HTN are at an increased risk for CV mortality and adverse CV events, including HF, AMI, AF, and ventricular arrhythmias, compared to those without HTN. While the overall risk of all-cause mortality was similar between the two groups, the findings underscore the importance of effective blood pressure management in this population to prevent future CV complications.