Women With Sarcoidosis Have Higher Mortality Risk From Heart Problems, Study Suggests

Women with sarcoidosis are more likely to die in hospital from heart complications and also to experience sudden cardiac death than male patients, while men are more likely to have a heart defibrillator device, a study reports.

These findings highlight the importance of recognizing how sex differences play a role in the prevalence and prognosis of heart complications in patients with sarcoidosis, investigators noted.

The study, “Gender Differences in Rates of Arrhythmias, Cardiac Implantable Electronic Devices, and Diagnostic Modalities Among Sarcoidosis Patients,” was published in the journal Cureus.

Sarcoidosis is a chronic inflammatory disease of unknown origin characterized by the presence of granulomas — small clumps of immune cells — in different organs. In some cases, the disease remains asymptomatic and the diagnosis is made by chance after patients are examined for other medical conditions.

“It has been noted that those presenting with cardiac [heart] symptoms have some of the poorest outcomes,” the researchers wrote. “These cardiac symptoms most often manifest in the form of life-threatening arrhythmias and sudden cardiac death.”

Sarcoidosis is known to be more prevalent among women than men. However, less is known about how sex differences affect the prevalence, type, and outcomes of heart complications in patients with sarcoidosis.

To address these questions, researchers analyzed data from a large population of adult patients with sarcoidosis from the U.S. National Inpatient Sample database, from 2010 to 2014.

Those with sarcoidosis who had a history of myocardial infarction (heart attack), or had previous procedures to unclog heart arteries were excluded from the study.

A total of 308,064 patients with a mean age of 55.65 years were included in the study. Most were women (65.2%) and of Black ethnicity (46.7%).

Results showed that the rate of in-hospital mortality in the overall population was 2.5%. However, when stratified by sex, the mortality rate for female patients (64%) was much higher than male patients (36%).

When analyzing and comparing the prevalence of different types of heart arrhythmias according to sex, investigators discovered that atrial fibrillation was more common in women (59% versus 41% in men), while ventricular tachycardia was more common in men (55%) than women (45%).

The female patients also had a higher prevalence of complete heart blocks (52% versus 48% in men) and sudden cardiac death (62% versus 38% in men). Of note, a complete heart block is a condition in which the electrical signals controlling heart beats are unable to travel normally between the different chambers of the heart.

Finally, the researchers found that men were more likely to have an implantable cardioverter-defibrillator (56% versus 44% in women) or a cardiac resynchronization therapy-defibrillator (58% versus 42% in women). However, women were more likely to have pacemakers than men (60% versus 40% in men).

Overall, “despite the greater procedural interventions required by males, our study shows that women with adverse cardiac events face poorer clinical outcomes as evidenced by the higher in-hospital mortality rates. This increased mortality depicts gender as an independent risk factor to the poor outcomes seen in sarcoidosis,” the researchers wrote.

Thus, “it is important to recognize the role of gender, as it plays a crucial role in the incidence and prognosis of cardiac events in sarcoidosis,” the team concluded.