Treatment of cardiac sarcoidosis: A comparative study of steroids and steroids plus immunosuppressive drugs.
Int J Cardiol
; 276: 208-211, 2019 Feb 01.
Article
em En
| MEDLINE
| ID: mdl-30527995
ABSTRACT
BACKGROUND:
We aimed to compare the efficacy of steroids alone or associated with immunosuppressive drugs for the prevention of relapse in cardiac sarcoidosis (CS).METHODS:
In this monocentric multidisciplinary retrospective single center study, all consecutive patients with histologically proven sarcoidosis hospitalized from January 2012 to December 2016 were considered. All patients with symptomatic CS were studied. Patients received steroids or steroids plus immunosuppressive drugs (IS) for CS treatment at diagnosis. The efficacy of each treatment strategy (steroids vs steroidsâ¯+â¯IS) was assessed by the cardiac relapse rate over follow up.RESULTS:
326 consecutive patients with histologically proven sarcoidosis were screened. Among them, 36 (11%) had symptomatic CS (20 (55.5%) men, median age at diagnosis 48.5 [22.8-76]). Twenty-four patients received steroids and 12 received steroidsâ¯+â¯IS (azathioprine nâ¯=â¯5, methotrexate nâ¯=â¯5, cyclophosphamide nâ¯=â¯2) at CS diagnosis. Over a median follow up of 3.6 [1-15.2] years, 13 (36.1%) patients suffered a cardiac relapse including reduced left ventricular ejection fraction (LVEF, nâ¯=â¯4), third degree heart block (nâ¯=â¯2), atrio-ventricular (nâ¯=â¯1) or ventricular (nâ¯=â¯1) tachycardia and sudden cardiac death (nâ¯=â¯1). Except for a higher frequency of black patients in patients receiving IS, CS features at diagnosis and median time to relapse did not significantly differ between patients who did or did not receive IS. Relapse rate was 45.8% in the steroids group versus 16.7% in the steroidsâ¯+â¯IS group (pâ¯=â¯0.048).CONCLUSIONS:
In cardiac sarcoidosis, the combination of steroids with immunosuppressive drugs might reduce the risk of cardiac relapse, as compared to steroids alone.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Sarcoidose
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Esteroides
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Imunossupressores
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Cardiomiopatias
Tipo de estudo:
Observational_studies
/
Prognostic_studies
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Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Int J Cardiol
Ano de publicação:
2019
Tipo de documento:
Article
País de afiliação:
França