{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T23:06:05Z","timestamp":1785539165245,"version":"3.56.0"},"reference-count":24,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"24","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,12,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">A multidisciplinary approach improves guideline\u2010directed medical therapy in systolic heart failure (HF), but its efficacy in patients with HF due to cardiac sarcoidosis is unreported.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              In a retrospective cohort study, we reviewed 848 patients from our institutional cardiac sarcoidosis clinics, identifying those with a cardiac sarcoidosis diagnosis, HF (left ventricular ejection fraction &lt;50%) at index evaluation, and echocardiograms within 90\u2009days and 11 to 36\u2009months. Patients were stratified by participation in a pharmacist\u2010led medication therapy management (MTM) program for guideline\u2010directed medical therapy optimization (MTM versus non\u2010MTM [NMTM]) without randomization. Demographics, left ventricular ejection fraction, guideline\u2010directed medical therapy (quantified by Kansas City Medical Optimization score), and immunosuppressive therapy were assessed. Primary outcomes included changes in Kansas City Medical Optimization score, left ventricular ejection fraction, and cardiovascular event\u2013free survival (unplanned HF hospitalization, left ventricular assist device \/heart transplant, or death). The final cohort included 111 patients (median age, 57\u2009years; 34% women; 64% New York Heart Association class I\u2013II); 43 (39%) were MTM and 68 (61%) were NMTM. Mean Kansas City Medical Optimization score was similar at index evaluation (MTM, 23.2; NMTM, 29.6;\n              <jats:italic>P<\/jats:italic>\n              =0.83). At follow\u2010up (median, 16\u2009months), the Kansas City Medical Optimization score increased significantly in both groups (MTM, 23.2 to 74.8;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001; NMTM, 29.6 to 58.7;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) but was higher in MTM (\n              <jats:italic>P<\/jats:italic>\n              =0.001). Mean left ventricular ejection fraction trended toward higher values in MTM (44.4% versus 40.0%,\n              <jats:italic>P<\/jats:italic>\n              =0.05). The primary clinical outcome occurred in 1 MTM (2.3%) and 16 NMTM (23.5%) patients, with higher risk in NMTM (hazard ratio, 11.97 [95% CI, 1.58\u201390.54];\n              <jats:italic>P<\/jats:italic>\n              =0.002).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">In this retrospective cohort study, a pharmacist\u2010led MTM program was associated with favorable guideline\u2010directed medical therapy optimization and lower risk of adverse cardiovascular outcomes in patients with cardiac sarcoidosis with HF.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.038965","type":"journal-article","created":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T19:30:43Z","timestamp":1731958243000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Pharmacist Medication Titration Program for Patients With Cardiac Sarcoidosis and Systolic Heart Failure: A Retrospective Cohort Study"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6195-8541","authenticated-orcid":false,"given":"Daniel","family":"Sykora","sequence":"first","affiliation":[{"name":"Mayo Clinic School of Graduate Medical Education Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Olson","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Mayo Clinic Rochester Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Churchill","sequence":"additional","affiliation":[{"name":"Mayo Clinic Alix School of Medicine Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B. Michelle","family":"Kim","sequence":"additional","affiliation":[{"name":"Mayo Clinic Alix School of Medicine Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie","family":"Bratcher","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Rochester Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9168-5855","authenticated-orcid":false,"given":"Mohamed","family":"Elwazir","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Rochester Rochester MN"},{"name":"Department of Cardiovascular Medicine Suez Canal University Ismailia Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7071-192X","authenticated-orcid":false,"given":"Kathleen","family":"Young","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Rochester Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sami","family":"Ryan","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Rochester Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Brodin","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Mayo Clinic Rochester Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Anderson","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Mayo Clinic Rochester Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremiah","family":"Saunders","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Mayo Clinic Rochester Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Abou Ezzeddine","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Rochester Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Bois","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Rochester Rochester MN"},{"name":"Department of Diagnostic Radiology Mayo Clinic Rochester Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5871-0265","authenticated-orcid":false,"given":"John","family":"Giudicessi","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Rochester Rochester MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1002-3313","authenticated-orcid":false,"given":"Leslie","family":"Cooper","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic Florida Jacksonville 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