TY - JOUR T1 - Effect of Myocardial Inflammation Suppression and Prednisone Therapy on Outcomes in Patients with Suspected Cardiac Sarcoidosis JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 1656 LP - 1656 VL - 62 IS - supplement 1 AU - Chaitanya Rojulpote AU - Abhijit Bhattaru AU - Pranav Karambelkar AU - Jose Rodriguez AU - Paco Bravo Y1 - 2021/05/01 UR - http://jnm.snmjournals.org/content/62/supplement_1/1656.abstract N2 - 1656Background: Patients with cardiac sarcoidosis (CS) are often treated with prednisone to suppress myocardial inflammation. However, there is little data on outcomes in relation to myocardial inflammation suppression and/or prednisone dose. Methods: We studied 106 patients with suspected CS (54.3±1.8 years, 27% females, 46.2% biopsy confirmed) who underwent PET imaging at the University of Pennsylvania from 2008 to 2020. Patients were selected if: 1) ≥2 PET scans, 2) positive inflammation on baseline scan, 3) no immunotherapy at baseline, 4) treated with prednisone only or no treatment (NT). Prednisone initiation dose was studied at low dose (Dlow) <30 mg/day, moderate dose (Dmod) 30-49 mg/day, and high dose (Dhigh) ≥50 mg/day. Baseline history was recorded. PET scans were reported as complete myocardial suppression/partial myocardial suppression (CMS/PMS) or no suppression. Major adverse cardiovascular events (MACE) were defined as sustained ventricular tachycardia/ventricular fibrillation (VT/VF), heart failure (HF) admission, and death. Results: Patients were followed for 4.7 years [IQR 3.1-7.8]. In total, there were 69 MACE (5 deaths, 49 HF admissions, 43 sustained VT/VF episodes). Patients that achieved CMS/PMS at follow-up did not have worse outcomes as compared to patients who achieved no suppression, both in a crude (p=0.985) and an adjusted model for prednisone dose (p=0.940). In a model adusted for significant baseline variables, patients started on HD prednisone had significantly worse outcomes as compared to patients on the NT, LD and MD prednisone groups (p=0.003, Figure 1). Conclusion:In patients with suspected CS, myocardial inflammation suppression was not predictive of MACE, whereas, HD prednisone treatment was associated with worse outcomes. Prospective, randomized control trials are needed to validate these findings. ER -