Cardiopulmonary Outcomes in Sarcoidosis Patients with Ocular Involvement: A Propensity-Score-Matched Analysis

To evaluate the risk of cardiopulmonary outcomes in patients with sarcoidosis and ocular involvement compared to those without.

This is a retrospective cohort study using the TriNetX Research Network, a federated, real-world database containing deidentified medical records from over 140 million patients across more than 100 global health care organizations. Adults (≥18 years) diagnosed with sarcoidosis between 2000 and 2022 were identified. Patients were stratified into cohorts by the presence or absence of ocular involvement and 1:1 propensity score matched by age, race/ethnicity, and comorbidities. Cohorts were monitored for up to 3 years for the development of cardiopulmonary outcomes. Risk was estimated using hazard ratios with 95% confidence intervals for each outcome.

After matching, each cohort contained 6,893 patients. Individuals with ocular involvement had significantly increased risk of developing ventricular arrhythmias (HR:1.61, 95% CI:1.15-2.23), heart failure (HR:1.27, 95% CI:1.07-1.50), and pulmonary hypertension (HR:1.27, 95% CI:1.00-1.59) at various points during the three-year follow-up interval. Risk of developing sarcoid myocarditis (HR:1.54, 95% CI:1.09-2.18) and sarcoidosis of the lung (HR:1.26, 95% CI:1.11-1.42) was highest one year after the index date and remained elevated throughout the study period. In subgroup analyses, elevated hazards ratios were additionally observed for pulmonary embolism (HR:1.72, 95% CI:1.05-2.81, males), atrioventricular block (HR:2.02, 95% CI:1.27-3.20, White patients), and acute myocardial infarction (HR:1.59, 95% CI:1.02-2.49, White patients).

In this large multicenter cohort, ocular involvement in sarcoidosis was associated with elevated cardiopulmonary risk, underscoring the need for vigilant systemic monitoring in this population.