Abstract
Introduction: Progressive loss of skeletal muscle termed “sarcopenia” is an independent risk factor for mortality in patients with cardiovascular diseases. Recently, a simple screening test that can identify sarcopenia using three variables (age, grip strength and calf circumference) has been developed. We utilized the screening test and assessed its clinical utility in patients with cardiovascular risk. Hypothesis: Simple sarcopenia screening test predicts future adverse events in patients with cardiovascular risk. Methods and Results: The study included 479 patients who have one or more risk factors. The sarcopenia screening score was calculated, and the patients were divided into sarcopenia (n=260) and non-sarcopenia (n=219) group. The sarcopenia group had significantly higher BNP, E/e’, and lower estimated glomerular filtration rate (eGFR) than the non-sarcopenia group. Multivariate linear regression analyses showed that the sarcopenia score correlated significantly with BNP independent of age, sex, hypertension, diabetes mellitus, and eGFR. In multivariate Cox proportional hazards analysis, BNP (ln[BNP]) (hazard ratio [HR]: 2.17; 95% confidence interval [CI]: 1.42-3.32, p<0.01), body mass index (HR: 1.23; 95%CI: 1.05-1.45; p=0.01), NYHA functional classification (HR: 2.84; 95%CI: 1.63-4.95, p<0.01) and the presence of sarcopenia (HR: 2.88; 95%CI: 1.06-7.82; p=0.04) were independent predictors of heart failure re-hospitalization. With regard to the gender difference, Kaplan-Meier curve revealed that event free survival rate was significantly lower only in the male, but not female sarcopenia group. In addition, serum brain-derived neurotrophic factor, known as a brain and skeletal muscle-derived protein, were significantly lower in the male sarcopenia group than non-sarcopenia group. Conclusions: Simple sarcopenia screening test could predict the future adverse events in male patients with cardiovascular risk.
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