Effect of Discontinuation of Prednisolone Therapy on Risk of Cardiac Mortality Associated With Worsening Left Ventricular Dysfunction in Cardiac Sarcoidosis

The American Journal of Cardiology
Toshiyuki NagaiToshihisa Anzai

Abstract

Prednisolone (PSL) therapy is the gold standard treatment in patients with cardiac sarcoidosis (CS). However, clinicians often have difficulty in deciding whether to discontinue PSL therapy in long-term management. Sixty-one consecutive patients with CS were divided into 2 groups based on the discontinuation of PSL during the median follow-up period of 9.9 years. PSL was discontinued in 12 patients because of improvement of clinical findings. There were no significant differences between the 2 groups in age, gender, left ventricular ejection fraction (LVEF), findings of imaging techniques, incidence of fatal arrhythmias and heart failure, and dose of PSL. After discontinuation of PSL, 5 patients had cardiac death, and discontinuation of PSL was significantly associated with higher cardiac mortality compared with continuation (p = 0.035). Although patients with discontinuation had improvement of LVEF after PSL treatment, LVEF decreased after discontinuation of PSL. Furthermore, discontinuation of PSL was associated with greater percent decrease in LVEF compared with continuation (p = 0.037) during the follow-up period. In conclusion, in the long-term management of patients with CS, discontinuation of PSL was associated with poor...Continue Reading

References

Nov 1, 1996·Cardiovascular Drugs and Therapy·M SekiguchiM Hiroe
Nov 13, 2001·The American Journal of Cardiology·Y YazakiUNKNOWN Central Japan Heart Study Group
Nov 5, 2004·Medicine·Catherine Chapelon-AbricJean-Charles Piette
Dec 28, 2004·The American Journal of Cardiology·Chiung-Zuan ChiuKunio Miyatake
Jan 18, 2006·Heart·Abdul R Doughan, Byron R Williams
Jun 10, 2006·The International Journal of Cardiovascular Imaging·Hideki FutamatsuMitsuaki Isobe
Sep 2, 2006·The European Respiratory Journal·J C Grutters, J M M van den Bosch
Sep 25, 2007·Orvosi hetilap·Tamás Kullmann
Nov 21, 2007·Orphanet Journal of Rare Diseases·Hilario NunesDominique Valeyre
Nov 23, 2007·The New England Journal of Medicine·Michael C IannuzziAlvin S Teirstein
Dec 29, 2007·Current Opinion in Ophthalmology·Ron Margolis, Careen Y Lowder
Apr 19, 2011·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·Kenji YodogawaKyoichi Mizuno
Sep 18, 2012·Current Treatment Options in Cardiovascular Medicine·Michelle BussinguerOm P Sharma
Apr 30, 2013·The Canadian Journal of Cardiology·Mouhannad M SadekPablo B Nery
May 14, 2014·Heart Rhythm : the Official Journal of the Heart Rhythm Society·David H BirnieKyoko Soejima
Apr 17, 2015·Circulation Journal : Official Journal of the Japanese Circulation Society·Toshiyuki NagaiToshihisa Anzai
Jun 25, 2015·European Heart Journal Cardiovascular Imaging·Niti R AggarwalPanithaya Chareonthaitawee

❮ Previous
Next ❯

Citations

Jul 5, 2017·Acta Cardiologica·Marijke TimmersGeert De Hondt
Jul 26, 2019·Current Opinion in Pulmonary Medicine·Vasileios KouranosRakesh Sharma
Jun 9, 2019·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Monica AhluwaliaLawrence M Phillips
Jun 28, 2020·Seminars in Respiratory and Critical Care Medicine·David H Birnie
Aug 1, 2019·Current Opinion in Pulmonary Medicine·Vasileios KouranosRakesh Sharma
May 6, 2017·Current Treatment Options in Cardiovascular Medicine·Laura YoungRory Hachamovitch
Sep 21, 2019·Journal of the American Heart Association·David G RosenthalVasanth Vedantham
Oct 30, 2020·Current Cardiology Reports·Sofia Carolina Masri, Lavanya Bellumkonda
Mar 7, 2021·Heart·Vasileios Kouranos, Rakesh Sharma
Jan 14, 2021·Arrhythmia & Electrophysiology Review·Nisha GilotraJonathan Chrispin
Jul 15, 2021·EClinicalMedicine·John A BelperioJoseph P Lynch
Jul 29, 2021·Journal of Cardiac Failure·Mohamed ElwazirShreyasee Amin
Sep 3, 2021·Journal of the American Heart Association·Siavosh FazelpourDavid H Birnie

❮ Previous
Next ❯

Related Concepts

Related Feeds

Atrial Fibrillation

Atrial fibrillation is a common arrhythmia that is associated with substantial morbidity and mortality, particularly due to stroke and thromboembolism. Here is the latest research.

Cardiovascular Diseases: Risk Factors

Cardiovascular disease is a significant health concern. Risk factors include hypertension, obesity, dyslipidemia and smoking. Women who are postmenopausal are at an increased risk of heart disease. Here is the latest research for risk factors of cardiovascular disease.

Cardiomyopathy

Cardiomyopathy is a disease of the heart muscle, that can lead to muscular or electrical dysfunction of the heart. It is often an irreversible disease that is associated with a poor prognosis. There are different causes and classifications of cardiomyopathies. Here are the latest discoveries pertaining to this disease.

Arrhythmia

Arrhythmias are abnormalities in heart rhythms, which can be either too fast or too slow. They can result from abnormalities of the initiation of an impulse or impulse conduction or a combination of both. Here is the latest research on arrhythmias.