Sarcopenia Index as a Predictor of Clinical Outcomes in Older Patients with Coronary Artery Disease.
Hak Seung LeeKyung Woo ParkJeehoon KangYou Jeong KiMineok ChangJung-Kyu HanHan Mo YangHyun-Jae KangBon-Kwon KooHyo-Soo KimPublished in: Journal of clinical medicine (2020)
To demonstrate the association of the serum creatinine/serum cystatin C ratio (sarcopenia index, SI) with clinical outcomes including cardiovascular and bleeding risk in older patients who underwent percutaneous coronary intervention (PCI), we analyzed a multicenter nation-wide pooled registry. A total of 1086 older patients (65 years or older) who underwent PCI with second-generation drug-eluting stents (DES) were enrolled. The total population was divided into quartiles according to the SI, stratified by sex. The primary clinical outcomes were major adverse cardiovascular events (MACE, all-cause death, myocardial infarction and target lesion revascularization) and thrombolysis in myocardial infarction major and minor bleeding during a 3-year follow-up period. In the total population, MACE occurred within 3 years in 154 (14.2%) patients. The lowest SI quartile group (Q1) had a significantly higher 3-year MACE rate (Q1 vs. Q2-4; 23.1% vs. 11.2%, p < 0.001), while bleeding event rates were similar between the groups (Q1 vs. Q2-4; 2.6% vs. 2.2%, p = 0.656). The Cox proportional hazard model showed that lower SI is an independent predictor for MACE events (HR 2.23, 95% CI 1.62-3.07, p < 0.001). The SI, a surrogate for the degree of muscle mass, is associated with cardiovascular and non-cardiovascular death, but not with bleeding in older patients who underwent PCI.
Keyphrases
- percutaneous coronary intervention
- atrial fibrillation
- coronary artery disease
- cardiovascular events
- st segment elevation myocardial infarction
- acute myocardial infarction
- st elevation myocardial infarction
- antiplatelet therapy
- acute coronary syndrome
- room temperature
- coronary artery bypass grafting
- community dwelling
- end stage renal disease
- heart failure
- left ventricular
- cardiovascular disease
- skeletal muscle
- newly diagnosed
- chronic kidney disease
- ejection fraction
- physical activity
- middle aged
- peritoneal dialysis
- prognostic factors
- clinical trial
- emergency department
- uric acid
- patient reported outcomes
- randomized controlled trial