Background and Aims

Inflammation plays a pivotal role in atherosclerosis, and the association between chronic inflammatory states and ischemic heart disease (IHD) was confirmed for several rheumatic diseases. Therefore, the constant state of inflammation to which sarcoidosis patients are exposed might pose as a risk factor for IHD.

The aim of this study is to assess the relation between sarcoidosis and IHD and its prognostic significance.

Methods

Based on data from Clalit Health Services, the largest healthcare organization in Israel, the medical records of 3,993 sarcoidosis patients and 19,856 controls were acquired. Controls were matched to sarcoidosis patients according to age and sex. Chi-square and student t-tests were used in order to compare variables distribution in the cohort. Variables associated with IHD were assessed by logistic regression model. Log-rank test was performed for survival analysis, while Cox proportional hazards method was utilised to evaluate variables related to increased risk of all-cause mortality.

Results

Sarcoidosis patients had a significantly higher proportion of IHD (856 cases, 21.4%) compared to controls (2999 cases, 15.1%, p < 0.001). A multivariate analysis demonstrated an association between sarcoidosis and IHD (adjusted OR 1.503, 95% CI 1.361–1.660). A 15-year follow-up revealed increased mortality among sarcoidosis patients: 710 (17.8%) deaths compared to 2121 (10.7%, p < 0.001). Sarcoidosis patients were also at increased risk for all-cause mortality compared to controls (multivariate model, adjusted HR 1.95, 95% CI 1.75–2.14).

Conclusions

Sarcoidosis is associated with greater risk for both ischemic hearth disease and all-cause mortality. Physicians should be alert of those risks when treating sarcoidosis patients.