title: Effect of Corticosteroid Therapy on Long-Term Clinical Outcome and Left Ventricular Function in Patients With Cardiac Sarcoidosis.
abstract: BACKGROUND
  Cardiac involvement is the worst prognostic determinant in patients with sarcoidosis, but the long-term prognostic significance of corticosteroid therapy for cardiac sarcoidosis (CS) remains unclear.
  
  
  RESULTS
  We examined 83 consecutive patients diagnosed with CS. Patients were divided into 2 groups based on the presence or absence of corticosteroid therapy at diagnosis. Patients with corticosteroid therapy had lower age and higher rate of positive findings in the myocardium on gallium scintigraphy (Ga) at diagnosis than those without. LVEF, biomarkers, and use of cardiovascular medication were similar between the 2 groups. During the follow-up (7.6±4.4 years), corticosteroid therapy was associated with fewer long-term adverse events (overall, P=0.005; cardiac death, P=0.92; symptomatic arrhythmias, P=0.89; heart failure admission, P<0.0001) and a greater % increase in LVEF than those without (7.9±36.3% vs. -16.7±34.8%, P=0.03). On Cox proportional hazards modeling, corticosteroid therapy (HR, 0.41; 95% CI: 0.20-0.89) was an independent determinant of long-term adverse event-free survival, but age, sex, LVEF, and Ga findings were not.
  
  
  CONCLUSIONS
  Corticosteroid therapy might have a beneficial effect on long-term clinical outcome in CS patients, particularly by reduction of heart failure admission and retarding the progression of LV systolic dysfunction.
authors: Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center.
authors: Toshiyuki
authors: T
authors: Nagai
authors: Nobutaka
authors: N
authors: Nagano
authors: Yasuo
authors: Y
authors: Sugano
authors: Yasuhide
authors: Y
authors: Asaumi
authors: Takeshi
authors: T
authors: Aiba
authors: Hideaki
authors: H
authors: Kanzaki
authors: Kengo
authors: K
authors: Kusano
authors: Teruo
authors: T
authors: Noguchi
authors: Satoshi
authors: S
authors: Yasuda
authors: Hisao
authors: H
authors: Ogawa
authors: Toshihisa
authors: T
authors: Anzai
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality / Q000503:physiopathology; D009202:Cardiomyopathies / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality / Q000503:physiopathology; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005708:Gallium / Q000008:administration & dosage; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D012507:Sarcoidosis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000401:mortality / Q000503:physiopathology; D012737:Sex Factors; D015996:Survival Rate; D016277:Ventricular Function, Left
chemical_list: D000305:Adrenal Cortex Hormones; D005708:Gallium