Decreased Appendicular Skeletal Muscle Mass is Associated with Poor Outcomes after ST-Segment Elevation Myocardial Infarction
| Autor: | Eiichi Akiyama, Toshiaki Ebina, Kiyoshi Hibi, Kouichi Tamura, Kozo Okada, Masaaki Konishi, Yasushi Matsuzawa, Nobuhiko Maejima, Hiroyuki Suzuki, Yuichiro Kimura, Stephan von Haehling, Noriaki Iwahashi, Chika Kawashima, Stefan D. Anker, Kazuo Kimura, Masami Kosuge, Ryosuke Sato |
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| Rok vydání: | 2020 |
| Předmět: |
Male
Sarcopenia medicine.medical_specialty 030204 cardiovascular system & hematology Skeletal muscle mass 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine Internal Medicine medicine Humans ST segment Myocardial infarction Muscle Skeletal Aged Aged 80 and over Ejection fraction business.industry Biochemistry (medical) Hazard ratio Middle Aged Prognosis medicine.disease Confidence interval 3. Good health ST-segment elevation myocardial infarction Quartile Heart failure Cardiology ST Elevation Myocardial Infarction Original Article Female Cardiology and Cardiovascular Medicine business 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Journal of Atherosclerosis and Thrombosis |
| ISSN: | 1880-3873 1340-3478 |
| Popis: | Aim: The importance of sarcopenia in cardiovascular diseases has been recently demonstrated. This study aims to examine whether skeletal muscle mass (SMM), an important component of sarcopenia, is associated with an increased risk of poor outcome in patients after ST-segment elevation myocardial infarction (STEMI). Methods: We measured SMM in 387 patients with STEMI using dual-energy X-ray absorptiometry. Patients were divided into low- and high-appendicular skeletal mass index (ASMI: appendicular SMM divided by height squared (kg/m2)) groups using the first quartile of ASMI (≤ 6.64 kg/m2 for men and ≤ 5.06 kg/m2 for women). All patients were followed up for the primary composite outcome of all-cause death, nonfatal myocardial infarction, nonfatal ischemic stroke, hospitalization for congestive heart failure, and unplanned revascularization. Results: Low-ASMI group was older and had a more complex coronary lesion, a lower left ventricular ejection fraction, and a higher prevalence of Killip classification ≥ 2 than high-ASMI group. During a median follow-up of 33 months, the event rate was significantly higher in low-ASMI group than in high-ASMI group (24.7% vs 13.4%, log-rank p = 0.001). Even after adjustment for patients' background, low ASMI was independently associated with the high risk of primary composite events (adjusted hazard ratio 2.06, 95% confidence interval 1.01–4.19, p = 0.04). In the subgroup analyses of male patients (n = 315), the optimal cutoff point of ASMI for predicting primary composite outcome was 6.75 kg/m2, which was close to its first quartile value. Conclusions: Low ASMI is independently associated with poor outcome in patients with STEMI. |
| Databáze: | OpenAIRE |
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