• Raheel Ahmed, Hiroyuki Sawatari, Khadija Amanullah, Joseph Okafor, Syed Emir Irfan Wafa, Saurabh Deshpande, Kamleshun Ramphul, Isma Ali, Mohammed Khanji, Sebastian Mactaggart, Omar Abou-Ezzeddine, Vasilis Kouranos, Rakesh Sharma, Virend K Somers, Selma F Mohammed, and ChahalC Anwar ACAADepartment of Cardiology, Barts Heart Centre, London, UK; Northumbria Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK; William Harvey Research Institute, Queen Mary University of London, London, UK; Center for Inherited Cardiovas.
• Cardiac Sarcoidosis Services, Royal Brompton Hospital, London, part of Guys and St Thomas's NHS Trust, London, UK.
• Am. J. Med. 2024 Aug 1; 137 (8): 751760.e8751-760.e8.

BackgroundSarcoidosis is associated with a poor prognosis. There is a lack of data examining the outcomes and readmission rates of sarcoidosis patients with heart failure (SwHF) and without heart failure (SwoHF). We aimed to compare the impact of non-ischemic heart failure on outcomes and readmissions in these two groups.MethodsThe US Nationwide Readmission Database was queried from 2010 to 2019 for SwHF and SwoHF patients identified using the International Classification of Diseases, 9th and 10th Editions. Those with ischemic heart disease were excluded, and both cohorts were propensity matched for age, gender, and Charlson Comorbidity Index (CCI). Clinical characteristics, length of stay, adjusted healthcare-associated costs, 90-day readmission and mortality were analyzed.ResultsWe identified 97,961 hospitalized patients (median age 63 years, 37.9% male) with a diagnosis of sarcoidosis (35.9% SwHF vs 64.1% SwoHF). On index admission, heart failure patients had higher prevalences of atrioventricular block (3.3% vs 1.4%, P < .0001), ventricular tachycardia (6.5% vs 1.3%, P < .0001), ventricular fibrillation (0.4% vs 0.1%, P < .0001) and atrial fibrillation (22.1% vs 7.5%, P < .0001). SwHF patients were more likely to be readmitted (hazard ratio 1.28, P < .0001), had higher length of hospital stay (5 vs 4 days, P < .0001), adjusted healthcare-associated costs ($9,667.0 vs $9,087.1, P < .0001) and mortality rates on readmission (5.1% vs 3.8%, P < .0001). Predictors of mortality included heart failure, increasing age, male sex, higher CCI, and liver disease.ConclusionSwHF is associated with higher rates of arrhythmia at index admission, as well as greater hospital cost, readmission and mortality rates compared to those without heart failure.Copyright © 2024 Elsevier Inc. All rights reserved.

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