Corticosteroid Therapy and Long-term Prognosis
A prospective randomized trial to investigate the efficacy of
corticosteroids in cardiac sarcoidosis is lacking. Several studies have
shown that early initiation of corticosteroids results in better
clinical outcomes.15, 16 The results in the present
study were concordant with that. Although the echocardiographic response
in group 1 was poorer than that in the other groups, the cardiovascular
death and heart failure hospitalizations in group 1 were low. Early
initiation of the corticosteroid therapy could prevent recurrent
inflammation and an expansion of sarcoidosis lesions. In fact, only 14%
of the patients in group 1 had active inflammation (increased FDG
uptake) of the heart, as compared to 70% in group 2. Progression of
abnormal CS lesions could be delayed or suppressed by earlier
corticosteroids therapy, which would improve their clinical outcomes.