Sarcopenia: prevalence and prognostic implications in elderly patients with cardiovascular disease

Kentaro Kamiya, Nobuaki Hamazaki, Ryota Matsuzawa, Kohei Nozaki, Shinya Tanaka, Yuta Ichinosawa, Emi Maekawa, Chiharu Noda, Minako Yamaoka-Tojo, Atsuhiko Matsunaga, Takashi Masuda, Junya Ako

Abstract


Background

Sarcopenia has recently been given an ICD-10 code. However, there have been no systematic investigations regarding the prevalence or prognostic value of sarcopenia in cardiovascular disease (CVD) according to the international consensus definition. The present study was performed to investigate the prevalence and prognostic value of sarcopenia in elderly patients with CVD.

Methods

The study population consisted of 1603 admitted patients aged ≥ 65 years (74.4 ± 6.2 years, 1049 men) with CVD. Sarcopenia was defined according to the recommended diagnostic algorithm of the Asia Working Group for Sarcopenia. The endpoint for the study was all-cause mortality.

Results

The overall sarcopenia prevalence rate was 29.7% (19.6% in men and 48.7% in women). The prevalence rates of sarcopenia across major diagnostic categories were as follows: acute coronary syndrome, 17.8%; post-cardiac surgery, 31.8%; and heart failure, 35.2%. During the 2.3 ± 2.1-year follow-up period, 175 deaths occurred. Patients with sarcopenia showed higher risk of all-cause mortality compared with non-sarcopenic patients (adjusted hazard ratio: 1.46; 95% confidence interval: 1.03 – 2.08; P = 0.036).

Conclusions

Sarcopenia is highly prevalent among elderly patients with CVD and is associated with increased mortality risk.


Full Text:

PDF

References


von Haehling S, Anker MS, Anker SD. Prevalence and clinical impact of cachexia in chronic illness in Europe, USA, and Japan: facts and numbers update 2016. J Cachexia Sarcopenia Muscle. 2016;7(5):507-9. doi:10.1002/jcsm.12167.

Kamiya K, Masuda T, Tanaka S, Hamazaki N, Matsue Y, Mezzani A, Matsuzawa R, Nozaki K, Maekawa E, Noda C, Yamaoka-Tojo M, Arai Y, Matsunaga A, Izumi T, Ako J. Quadriceps strength as a predictor of mortality in coronary artery disease. Am J Med. 2015;128(11):1212-19. doi:10.1016/j.amjmed.2015.06.035.

Dupuy C, Lauwers-Cances V, Guyonnet S, Gentil C, Abellan Van Kan G, Beauchet O, Schott AM, Vellas B, Rolland Y. Searching for a relevant definition of sarcopenia: results from the cross-sectional EPIDOS study. J Cachexia Sarcopenia Muscle. 2015;6(2):144-54. doi:10.1002/jcsm.12021.

Yang M, Hu X, Wang H, Zhang L, Hao Q, Dong B. Sarcopenia predicts readmission and mortality in elderly patients in acute care wards: a prospective study. J Cachexia Sarcopenia Muscle. 2016. doi:10.1002/jcsm.12163.

Tyrovolas S, Koyanagi A, Olaya B, Ayuso-Mateos JL, Miret M, Chatterji S, Tobiasz-Adamczyk B, Koskinen S, Leonardi M, Haro JM. Factors associated with skeletal muscle mass, sarcopenia, and sarcopenic obesity in older adults: a multi-continent study. J Cachexia Sarcopenia Muscle. 2016;7(3):312-21. doi:10.1002/jcsm.12076.

Anker SD, Morley JE, von Haehling S. Welcome to the ICD-10 code for sarcopenia. J Cachexia Sarcopenia Muscle. 2016;7(5):512-4. doi:10.1002/jcsm.12147.

Dodds RM, Granic A, Davies K, Kirkwood TB, Jagger C, Sayer AA. Prevalence and incidence of sarcopenia in the very old: findings from the Newcastle 85+ Study. J Cachexia Sarcopenia Muscle. 2017;8(2):229-37. doi:10.1002/jcsm.12157.

Patil R, Uusi-Rasi K, Pasanen M, Kannus P, Karinkanta S, Sievanen H. Sarcopenia and osteopenia among 70-80-year-old home-dwelling Finnish women: prevalence and association with functional performance. Osteoporos Int. 2013;24(3):787-96. doi:10.1007/s00198-012-2046-2.

Landi F, Liperoti R, Russo A, Giovannini S, Tosato M, Barillaro C, Capoluongo E, Bernabei R, Onder G. Association of anorexia with sarcopenia in a community-dwelling elderly population: results from the ilSIRENTE study. Eur J Nutr. 2013;52(3):1261-8. doi:10.1007/s00394-012-0437-y.

Yuki A, Ando F, Otsuka R, Shimokata H. Sarcopenia based on the Asian Working Group for Sarcopenia criteria and all-cause mortality risk in older Japanese adults. Geriatr Gerontol Int. 2017. doi:10.1111/ggi.12946.

Gariballa S, Alessa A. Sarcopenia: prevalence and prognostic significance in hospitalized patients. Clin Nutr. 2013;32(5):772-6. doi:10.1016/j.clnu.2013.01.010.

Morandi A, Onder G, Fodri L, Sanniti A, Schnelle J, Simmons S, Landi F, Gentile S, Trabucchi M, Bellelli G. The Association Between the Probability of Sarcopenia and Functional Outcomes in Older Patients Undergoing In-Hospital Rehabilitation. J Am Med Dir Assoc. 2015;16(11):951-6. doi:10.1016/j.jamda.2015.05.010.

Tanaka S, Kamiya K, Hamazaki N, Matsuzawa R, Nozaki K, Maekawa E, Noda C, Yamaoka-Tojo M, Matsunaga A, Masuda T, Ako J. Utility of SARC-F for Assessing Physical Function in Elderly Patients With Cardiovascular Disease. J Am Med Dir Assoc. 2017;18(2):176-81. doi:10.1016/j.jamda.2016.10.019.

Bianchi L, Abete P, Bellelli G, Bo M, Cherubini A, Corica F, Di Bari M, Maggio M, Manca GM, Rizzo MR, Rossi AP, Landi F, Volpato S, Investigators GG. Prevalence and Clinical Correlates of Sarcopenia, Identified According to the EWGSOP Definition and Diagnostic Algorithm, in Hospitalized Older People: The GLISTEN Study. J Gerontol A Biol Sci Med Sci. 2017. doi:10.1093/gerona/glw343.

Bastiaanse LP, Hilgenkamp TI, Echteld MA, Evenhuis HM. Prevalence and associated factors of sarcopenia in older adults with intellectual disabilities. Res Dev Disabil. 2012;33(6):2004-12. doi:10.1016/j.ridd.2012.06.002.

Landi F, Liperoti R, Fusco D, Mastropaolo S, Quattrociocchi D, Proia A, Tosato M, Bernabei R, Onder G. Sarcopenia and mortality among older nursing home residents. J Am Med Dir Assoc. 2012;13(2):121-6. doi:10.1016/j.jamda.2011.07.004.

Ethgen O, Beaudart C, Buckinx F, Bruyère O, Reginster JY. The Future Prevalence of Sarcopenia in Europe: A Claim for Public Health Action. Calcif Tissue Int. 2017;100(3):229-34. doi:10.1007/s00223-016-0220-9.

von Haehling S, Ebner N, dos Santos MR, Springer J, Anker SD. Muscle wasting and cachexia in heart failure: mechanisms and therapies. Nat Rev Cardiol. 2017;advance online publication. doi:10.1038/nrcardio.2017.51.

Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, Martin FC, Michel JP, Rolland Y, Schneider SM, Topinkova E, Vandewoude M, Zamboni M. Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People. Age Ageing. 2010;39(4):412-23. doi:10.1093/ageing/afq034.

Fielding RA, Vellas B, Evans WJ, Bhasin S, Morley JE, Newman AB, Abellan van Kan G, Andrieu S, Bauer J, Breuille D, Cederholm T, Chandler J, De Meynard C, Donini L, Harris T, Kannt A, Keime Guibert F, Onder G, Papanicolaou D, Rolland Y, Rooks D, Sieber C, Souhami E, Verlaan S, Zamboni M. Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia. J Am Med Dir Assoc. 2011;12(4):249-56. doi:10.1016/j.jamda.2011.01.003.

Chen LK, Liu LK, Woo J, Assantachai P, Auyeung TW, Bahyah KS, Chou MY, Chen LY, Hsu PS, Krairit O, Lee JS, Lee WJ, Lee Y, Liang CK, Limpawattana P, Lin CS, Peng LN, Satake S, Suzuki T, Won CW, Wu CH, Wu SN, Zhang T, Zeng P, Akishita M, Arai H. Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc. 2014;15(2):95-101. doi:10.1016/j.jamda.2013.11.025.

Kamiya K, Masuda T, Matsue Y, Hamazaki N, Matsuzawa R, Tanaka S, Nozaki K, Maekawa E, Noda C, Yamaoka-Tojo M, Matsunaga A, Ako J. Prognostic Usefulness of Arm and Calf Circumference in Patients >/=65 Years of Age With Cardiovascular Disease. Am J Cardiol. 2017;119(2):186-91. doi:10.1016/j.amjcard.2016.09.040.

Wen X, Wang M, Jiang CM, Zhang YM. Anthropometric equation for estimation of appendicular skeletal muscle mass in Chinese adults. Asia Pac J Clin Nutr. 2011;20(4):551-6.

Hu X, Zhang L, Wang H, Hao Q, Dong B, Yang M. Malnutrition-sarcopenia syndrome predicts mortality in hospitalized older patients. Sci Rep. 2017;7(1):3171. doi:10.1038/s41598-017-03388-3.

Han P, Kang L, Guo Q, Wang J, Zhang W, Shen S, Wang X, Dong R, Ma Y, Shi Y, Shi Z, Li H, Li C, Ma Y, Wang L, Niu K. Prevalence and factors associated with Sarcopenia in suburb-dwelling older Chinese using the Asian Working Group for Sarcopenia Definition. J Gerontol A Biol Sci Med Sci. 2016;71(4):529-35. doi:10.1093/gerona/glv108.

Yu R, Leung J, Woo J. Incremental predictive value of sarcopenia for incident fracture in an elderly Chinese cohort: results from the Osteoporotic Fractures in Men (MrOs) Study. J Am Med Dir Assoc. 2014;15(8):551-8. doi:10.1016/j.jamda.2014.02.005.

Fulster S, Tacke M, Sandek A, Ebner N, Tschope C, Doehner W, Anker SD, von Haehling S. Muscle wasting in patients with chronic heart failure: results from the studies investigating co-morbidities aggravating heart failure (SICA-HF). Eur Heart J. 2013;34(7):512-9. doi:10.1093/eurheartj/ehs381.

Bekfani T, Pellicori P, Morris DA, Ebner N, Valentova M, Steinbeck L, Wachter R, Elsner S, Sliziuk V, Schefold JC, Sandek A, Doehner W, Cleland JG, Lainscak M, Anker SD, von Haehling S. Sarcopenia in patients with heart failure with preserved ejection fraction: Impact on muscle strength, exercise capacity and quality of life. Int J Cardiol. 2016;222:41-6. doi:10.1016/j.ijcard.2016.07.135.

DiBello JR, Miller R, Khandker R, Bourgeois N, Galwey N, Clark RV. Association between low muscle mass, functional limitations and hospitalisation in heart failure: NHANES 1999-2004. Age Ageing. 2015;44(6):948-54. doi:10.1093/ageing/afv129.

Lo AX, Donnelly JP, McGwin G, Jr., Bittner V, Ahmed A, Brown CJ. Impact of gait speed and instrumental activities of daily living on all-cause mortality in adults >/=65 years with heart failure. Am J Cardiol. 2015;115(6):797-801. doi:10.1016/j.amjcard.2014.12.044.

Huded CP, Huded JM, Friedman JL, Benck LR, Lindquist LA, Holly TA, Sweis RN, Ricciardi MJ, Malaisrie SC, Davidson CJ, Flaherty JD. Frailty status and outcomes after transcatheter aortic valve implantation. Am J Cardiol. 2016;117(12):1966-71. doi:10.1016/j.amjcard.2016.03.044.

Cheung CL, Lam KS, Cheung BM. Evaluation of Cutpoints for Low Lean Mass and Slow Gait Speed in Predicting Death in the National Health and Nutrition Examination Survey 1999-2004. J Gerontol A Biol Sci Med Sci. 2016;71(1):90-5. doi:10.1093/gerona/glv112.

Yuki A, Ando F, Otsuka R, Matsui Y, Harada A, Shimokata H. Epidemiology of sarcopenia in elderly Japanese. The Journal of Physical Fitness and Sports Medicine. 2015;4(1):111-5.

Bianchi L, Ferrucci L, Cherubini A, Maggio M, Bandinelli S, Savino E, Brombo G, Zuliani G, Guralnik JM, Landi F, Volpato S. The Predictive Value of the EWGSOP Definition of Sarcopenia: Results From the InCHIANTI Study. J Gerontol A Biol Sci Med Sci. 2016;71(2):259-64. doi:10.1093/gerona/glv129.

Vetrano DL, Landi F, Volpato S, Corsonello A, Meloni E, Bernabei R, Onder G. Association of sarcopenia with short- and long-term mortality in older adults admitted to acute care wards: results from the CRIME study. J Gerontol A Biol Sci Med Sci. 2014;69(9):1154-61. doi:10.1093/gerona/glu034.

Beaudart C, Zaaria M, Pasleau F, Reginster J-Y, Bruyère O. Health Outcomes of Sarcopenia: A Systematic Review and Meta-Analysis. PLoS One. 2017;12(1):e0169548. doi:10.1371/journal.pone.0169548.

Kim JH, Lim S, Choi SH, Kim KM, Yoon JW, Kim KW, Lim JY, Park KS, Jang HC. Sarcopenia: an independent predictor of mortality in community-dwelling older Korean men. J Gerontol A Biol Sci Med Sci. 2014;69(10):1244-52. doi:10.1093/gerona/glu050.

Afilalo J, Kim S, O’Brien S, et al. Gait speed and operative mortality in older adults following cardiac surgery. JAMA Cardiology. 2016. doi:10.1001/jamacardio.2016.0316.

Trevino-Aguirre E, Lopez-Teros T, Gutierrez-Robledo L, Vandewoude M, Perez-Zepeda M. Availability and use of dual energy X-ray absorptiometry (DXA) and bio-impedance analysis (BIA) for the evaluation of sarcopenia by Belgian and Latin American geriatricians. J Cachexia Sarcopenia Muscle. 2014;5(1):79-81. doi:10.1007/s13539-013-0126-6.

Arai H, Akishita M, Chen LK. Growing research on sarcopenia in Asia. Geriatr Gerontol Int. 2014;14 Suppl 1:1-7. doi:10.1111/ggi.12236.

Bosaeus I, Wilcox G, Rothenberg E, Strauss BJ. Skeletal muscle mass in hospitalized elderly patients: comparison of measurements by single-frequency BIA and DXA. Clin Nutr. 2014;33(3):426-31. doi:10.1016/j.clnu.2013.06.007.

Reiss J, Iglseder B, Kreutzer M, Weilbuchner I, Treschnitzer W, Kassmann H, Pirich C, Reiter R. Case finding for sarcopenia in geriatric inpatients: performance of bioimpedance analysis in comparison to dual X-ray absorptiometry. BMC Geriatr. 2016;16:52. doi:10.1186/s12877-016-0228-z.




DOI: http://dx.doi.org/10.17987/jcsm-cr.v2i2.41

Refbacks

  • There are currently no refbacks.