PS-C25-7: PROGNOSTIC VALUE OF COMPUTED TOMOGRAPHY PSOAS MUSCLE SIZE IN PREDICTING MAJOR ADVERSE CARDIOVASCULAR EVENTS IN THE ELDERLY: A META-ANALYSIS.

Abstract

Background: Cardiovascular diseases (CVD) are the leading cause of death globally (WHO). It accounts for > 17 million deaths each year (30% of all deaths) (WONG, 2014). Aging is associated with body composition changes such as a reduction in the muscle mass and an increase in visceral fat that shift the metabolism to an unfavorable state which increases the risk of CVD (EVANS, 2021). Psoas muscle mass index (PMI) has been growing recognition as an objective and quantitative marker to assess muscle wasting and has been suggested as a useful predictive marker for long-term outcome after cardiovascular surgery (MATSUMOTO, 2020). The aim of this study is to determine the prognostic value of psoas muscle size for development of major adverse cardiovascular events. Methodology: We searched PubMed and Google scholar. The Newcastle-Ottawa Scale assessment was used for quality assessment. Two investigators independently extracted patient baseline characteristics, CT psoas muscle size, and research endpoint such as all-cause mortality, myocardial infarction, and stroke. The hazard ratio (95% CI) and relative risk (95% CI) was calculated using a generic inverse variance approach. The overall effects was determined by Z-test and P-value < 0.05 were considered as statistically significant. Results: Out of 37 articles, 10 citations fulfilled the inclusion criteria. Sarcopenia was not associated with MACE (HR 14.6, 95% CI:5.69 - 37.48, p value < 0.00001, I2 0%) and all cause mortality (RR 2.04, 95% CI:1.55 - 2.69, p value of < 0.00001, I2 0%). The sub-group analysis shows no association between sarcopenia and MACE among patients > 60 years (HR 15.36, 95% CI: 5.54 - 42.53, p value < 0.0001, I2 0%), myocardial infarction (RR 1.96, 95% CI: 0.63 - 6.10, p value of < 0.24, I2 0%), and stroke (RR 1.62, 95% CI: 0.84 - 3.15, p value of < 0.15, I2 0%). Conclusion: Sarcopenia is not associated with MACE and all cause mortality. Among patients > 60 years, sarcopenia shows no association between myocardial infarction and stroke. Further studies should be done to determine the cut-off value for psoas muscle size for sarcopenia and sarcopenic obesity among elderly patients.