Comparative Outcomes of Antiarrhythmic Therapy Alone Versus Combined Immunosuppressive Strategies in Sarcoidosis With Ventricular Tachycardia

Document Type

Conference Proceeding

Publication Date

4-7-2026

Publication Title

Journal of the American College of Cardiology

Abstract

tachycardia (VT). However, the effect of immunosuppressive therapy on VT outcomes remains poorly defined. METHODS We used TriNetX to identify adults with sarcoidosis and VT treated with antiarrhythmic drugs (AAD: amiodarone/sotalol). Patients were grouped into three groups: AAD only, AAD+steroids, and AAD+steroids+immunosuppressants (e.g., methotrexate, azathioprine, infliximab). Five-year outcomes were all-cause mortality, all-cause hospitalization, cardiac arrest, and heart failure (HF) exacerbation. RESULTS We included 3,511 patients (AAD-only: 1,303 [37.1%; 63.1±12.9 years]; AAD+steroids: 1,048 [29.8%; 62.2 ± 12.5 years]; AAD+steroids+immunosuppressants: 1,160 [33.0%; 56.4 ± 11.2 years]). After PSM, outcomes were similar between the AAD-only and AAD+steroids groups (all-cause mortality [32.1% vs. 27.6%, P=0.60], all-cause hospitalization [72.2% vs. 72.0%, P=0.13], cardiac arrest [15.5% vs. 14.4%, P=0.81], or HF exacerbation [31.2% vs. 31.3%, P=0.27]). AAD+steroids+immunosuppressants was associated with lower all-cause mortality than AAD-only (19.6% vs. 24.0%, P< 0.01) and AAD+steroids (21.9% vs. 29.5%, P< 0.01), without differences in hospitalization, cardiac arrest, or HF exacerbation. CONCLUSION In this 5-year retrospective study, adding immunosuppressive therapy to AADs in sarcoidosis with VT was linked to reduced all-cause mortality.

Volume

87

Issue

13 Suppl

First Page

A128

Comments

American College of Cardiology 75th Annual Scientific Session & Expo, March 28-30, 2026, New Orleans, LA

Last Page

A128

DOI

10.1016/j.jacc.2026.02.323

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