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Risk of acute myocardial infarction in sarcoidosis: A population-based cohort study from Sweden
Marios Rossides1, Susanna Kullberg2, Johan Grunewald2
1Clinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden; Unit of Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
Insights
Individuals with sarcoidosis have a slightly increased risk of acute myocardial infarction. This risk was highest for those treated with immunosuppressants around diagnosis.
Area of Science:
- Cardiology
- Immunology
- Public Health
Background:
- Conflicting evidence exists regarding the association between sarcoidosis and acute myocardial infarction (AMI) risk.
- Sarcoidosis is a systemic inflammatory disease with potential cardiovascular implications.
Purpose of the Study:
- To investigate the relative risk of AMI in individuals diagnosed with sarcoidosis compared to the general population.
- To explore variations in AMI risk based on patient demographics and treatment status.
Main Methods:
- A nationwide Swedish cohort study design.
- Inclusion of individuals with sarcoidosis and matched general population comparators.
- Follow-up for incident acute myocardial infarction using national health registers.
Main Results:
- A modest 20% increased relative risk of AMI was identified in the sarcoidosis cohort.
- The increased risk was consistent across different age groups, sexes, and time since diagnosis.
- Individuals receiving immunosuppressant treatment around the time of sarcoidosis diagnosis exhibited the highest relative risk (1.4).
Conclusions:
- Sarcoidosis is associated with a small but significant increase in the risk of acute myocardial infarction.
- Immunosuppressant therapy around diagnosis may further elevate this cardiovascular risk.
- Further research is warranted to understand AMI clinical characteristics and explore preventive strategies in sarcoidosis patients.
Abstract:
Due to conflicting findings in previous studies, it remains unclear whether individuals with sarcoidosis are at a higher relative risk of acute myocardial infarction. In this cohort study, individuals with sarcoidosis and matched general population comparators were followed for acute myocardial infarction in Swedish nationwide registers. A small (20%) risk increase associated with sarcoidosis was identified, which did not markedly vary by age at diagnosis, sex, treatment status around diagnosis, and time since diagnosis. The highest relative risk (1.4) was observed in individuals who received immunosuppressant treatment around the time of sarcoidosis diagnosis. Future studies should examine the clinical characteristics of acute myocardial infarction in these patients and investigate whether early diagnostic or preventive interventions might be beneficial for these patients.