Clinical outcomes of isolated versus systemic cardiac sarcoidosis: a systematic review and meta-analysis
Year: 2025
Type: review
Study designs: Systematic Review, Meta-Analysis
Abstract: Introduction Isolated cardiac sarcoidosis (ICS) is characterized by a lack of the apparent extra-cardiac involvement seen in systemic cardiac sarcoidosis (SCS) and is being increasingly recognized as a distinct clinical phenotype of cardiac sarcoidosis. This systematic review and meta-analysis pooled data from published literature to assess any differences in outcomes of ICS vs. SCS patients. Material and methods Studies were identified from PubMed/Medline, Embase, and the Cochrane Library. Risk ratios were calculated using the Mantel-Haenszel method in a random effects model. Heterogeneity was assessed using the Higgins I2 statistic. Leave-one-out sensitivity analysis was also performed. The primary outcome was a composite of MACE, including cardiac death, ventricular arrhythmias, or hospitalization for heart failure. The secondary outcomes included sudden cardiac death, arrhythmias, and heart-failure-related hospitalizations. Results The analysis included 7 studies and 918 CS patients (28.9% ICS and 71.1% SCS). Increased risk for arrhythmias (RR = 3.06, 95% CI: 0.98 to 9.55, p = 0.05, I2 = 67%) in patients with ICS compared to SCS was observed. No significant difference was observed for composite outcome (RR = 1.43, 95% CI: 0.93 to 2.18, p = 0.10, I2 = 0%), HF-related hospitalizations (RR = 6.83, 95% CI: 0.47 to 100.33, p = 0.16, I2 = 80%), or cardiac death (RR = 1.85, 95% CI: 0.49 to 7.08, p = 0.37, I2 = 0%) between the two groups. Conclusions Although ICS patients were more likely to experience arrhythmias, no significant difference was observed between ICS and SCS patients for composite outcome, cardiac death, or hospitalizations due to heart failure.
DOI: 10.5114/amsad/209036
Authors: Raheel Ahmed, Areeba Ahsan, Mushood Ahmed, Kamleshun Ramphul, Hritvik Jain, Syed Faisal Ali, Adnan Hasan Afridi, Renju Philip Thomas, Nimra Zuberi, Muhammad Easa Khan, Irfan Rind, Mohammad Saddam Jeelani, Mohsin Zia Sana Ullah, Nitish Kumar Behary Paray
Institutions: Royal Brompton Hospital, Imperial College London, Foundation University Islamabad, Rawalpindi Medical University, All India Institute of Medical Sciences Jodhpur, Royal Devon University Healthcare NHS Foundation Trust, Sunderland Royal Hospital, Derriford Hospital, University Hospitals Plymouth NHS Trust, South Tyneside and Sunderland NHS Foundation Trust, Monklands Hospital, Wrexham Maelor Hospital, University Hospitals Birmingham NHS Foundation Trust
Language: English
Subfield: Physiology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4415648644
