Sex differences in clinical characteristics and prognosis of patients with cardiac sarcoidosis

Heart. 2023 Aug 24;109(18):1387-1393. doi: 10.1136/heartjnl-2022-322243.

Abstract

Objective: Owing to the paucity of data, this study aimed to investigate sex differences in clinical features and prognosis of patients with cardiac sarcoidosis (CS).

Methods: This study was a secondary analysis of the ILLUstration of the Management and prognosIs of JapaNese PATiEnts with Cardiac Sarcoidosis registry-a retrospective multicentre registry that enrolled patients with CS between 2001 and 2017. The primary outcome was potentially fatal ventricular arrhythmia events (pFVAEs)-a composite of sudden cardiac death, sustained ventricular tachycardia lasting >30 s, ventricular fibrillation or the requirement for implantable cardioverter defibrillator therapy.

Results: Of the 512 participants (mean age±SD 61.6±11.4 years), 329 (64.2%) were females. Both sexes had peak ages of 60-64 years at diagnosis. Male patients were younger and had a higher prevalence of coronary artery disease and lower left ventricular ejection fraction than female patients. During a median follow-up of 3 years (IQR 1.6-5.6), pFVAEs were observed in 99 patients, with males having a significantly higher risk than females (p=0.002). This association was retained even after adjustment for other risk factors for pFVAEs, including left ventricular ejection fraction (adjusted HR 1.80; 95% CI 1.08 to 3.01, p=0.025).

Conclusion: Approximately two-thirds of patients with CS were females, with a peak age of approximately 60 years at clinical diagnosis in both sexes; male patients were younger than female patients. Male patients had a significantly higher risk of pFVAEs than female patients.

Trial registration number: UMIN000034974.

Keywords: cardiomyopathies; epidemiology; tachycardia, ventricular; ventricular fibrillation.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Arrhythmias, Cardiac / complications
  • Cardiomyopathies* / diagnosis
  • Cardiomyopathies* / epidemiology
  • Cardiomyopathies* / therapy
  • Death, Sudden, Cardiac / epidemiology
  • Death, Sudden, Cardiac / etiology
  • Death, Sudden, Cardiac / prevention & control
  • Defibrillators, Implantable* / adverse effects
  • Electric Countershock / adverse effects
  • Female
  • Humans
  • Male
  • Middle Aged
  • Myocarditis*
  • Prognosis
  • Retrospective Studies
  • Sarcoidosis* / complications
  • Sarcoidosis* / diagnosis
  • Sarcoidosis* / epidemiology
  • Sex Characteristics
  • Stroke Volume
  • Tachycardia, Ventricular* / diagnosis
  • Tachycardia, Ventricular* / epidemiology
  • Tachycardia, Ventricular* / etiology
  • Ventricular Function, Left

Associated data

  • UMIN-CTR/UMIN000034974