• Chest · Jan 2024

    Long-term risk of venous thromboembolism in sarcoidosis: a nationwide cohort study.

    • Adelina Yafasova, Emil L Fosbøl, Finn Gustafsson, Sophine B Krintel, Søren L Kristensen, Morten Schou, Jeppe K Petersen, Guoli Sun, Kasper Rossing, Seiko N Doi, Lars Køber, and Jawad H Butt.
    • Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark. Electronic address: adelinay@hotmail.com.
    • Chest. 2024 Jan 29.

    BackgroundChronic inflammation is increasingly recognized as a risk factor for VTE, but unlike other inflammatory diseases including systemic lupus erythematosus and rheumatoid arthritis, data on the risk of VTE in patients with sarcoidosis are sparse.Research QuestionDo patients with sarcoidosis have a higher long-term risk of VTE (pulmonary embolism or DVT, and each of these individually) compared with the background population?Study Design And MethodsUsing Danish nationwide registries, patients aged ≥ 18 years with newly diagnosed sarcoidosis (two or more inpatient/outpatient visits, 1996-2020) without prior VTE were matched 1:4 by age, sex, and comorbidities with individuals from the background population. The primary outcome was VTE.ResultsWe included 14,742 patients with sarcoidosis and 58,968 matched individuals (median age, 44.7 years; 57.2% male). The median follow-up was 8.8 years. Absolute 10-year risks of outcomes for patients with sarcoidosis vs the background population were the following: VTE, 2.9% vs 1.6% (P < .0001), pulmonary embolism, 1.5% vs 0.7% (P < .0001), and DVT, 1.6% vs 1.0% (P < .0001), respectively. In multivariable Cox regression, sarcoidosis was associated with an increased rate of all outcomes in the first year after diagnosis (VTE: hazard ratio [HR], 4.94; 95% CI, 3.61-6.75) and after the first year (VTE: HR, 1.65; 95% CI, 1.45-1.87) compared with the background population. These associations persisted when excluding patients with a history of cancer and censoring patients with incident cancer during follow-up. Three-month mortality was not significantly different between patients with VTE with and without sarcoidosis (adjusted HR, 0.84; 95% CI, 0.61-1.15).InterpretationIn this nationwide cohort study, sarcoidosis was associated with a higher long-term risk of VTE compared with a matched background population.Copyright © 2024 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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