Sarcopenia is a risk factor for cardiovascular events experienced by patients with critical limb ischemia

Yutaka Matsubara, takuya matsumoto, Kentaro Inoue, Daisuke Matsuda, Ryosuke Yoshiga, Keiji Yoshiya, Tadashi Furuyama, Yoshihiko Maehara

研究成果: ジャーナルへの寄稿記事

9 引用 (Scopus)

抄録

Background Prognosis is poor for patients with critical limb ischemia (CLI), and the most frequent cause of death is cardiovascular disease. Low grip strength is a risk factor for cardiovascular events, and sarcopenia may be associated as well. Thus, we hypothesized that sarcopenia is a risk factor for cardiovascular events experienced by patients with CLI. If this is true and appropriate therapy becomes available, the prognosis of patients with CLI will improve with appropriate risk management strategies to prevent cardiovascular events. Therefore, the aim of this study was to verify this hypothesis. Methods We studied 114 patients who underwent revascularization and computed tomography between January 2002 and December 2012 in the Department of Surgery and Sciences at Kyushu University in Japan. Sarcopenia was defined as skeletal muscle area measured by L3-level computed tomography scan <114.0 cm2 and <89.8 cm2 for men and women, respectively. Clinical characteristics, cardiovascular event-free survival, <2-year death, causes of death, and effective treatments for sarcopenia were investigated. Results We identified 53 (46.5%) patients with sarcopenia. Three-year cardiovascular event-free survival rates were 43.1% and 91.2% for patients with and without sarcopenia, respectively (P <.01). During follow-up, cardiovascular disease caused the deaths of 4 and 15 patients without and with sarcopenia (P <.01), respectively, and in particular, ischemic heart disease caused the deaths of 0 and 5 patients without or with sarcopenia (P <.05), respectively. Single antiplatelet therapy (SAPT; hazard ratio, 0.46; 95% confidence interval, 0.24-0.82; P <.01) and statin therapy (hazard ratio, 0.38; 95% confidence interval, 0.16-0.78; P <.01) were independent factors associated with improved cardiovascular event-free survival. Three-year cardiovascular event-free survival rates for patients with sarcopenia who received SAPT, dual antiplatelet therapies, and no antiplatelet therapy were 75.3%, 21.1%, and 29.5%, respectively (P <.01). Conclusions Sarcopenia is a risk factor for worse cardiovascular event-free survival, and SAPT and statin therapy reduced this risk for patients with CLI. Furthermore, SAPT but not dual antiplatelet therapy increased cardiovascular event-free survival in patients with sarcopenia.

元の言語英語
ページ(範囲)1390-1397
ページ数8
ジャーナルJournal of Vascular Surgery
65
発行部数5
DOI
出版物ステータス出版済み - 5 1 2017

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Sarcopenia
Ischemia
Extremities
Disease-Free Survival
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Therapeutics
Cause of Death
Cardiovascular Diseases
Survival Rate
Tomography
Confidence Intervals
Risk Management
Hand Strength
Myocardial Ischemia
Japan
Skeletal Muscle

All Science Journal Classification (ASJC) codes

  • Surgery
  • Cardiology and Cardiovascular Medicine

これを引用

Matsubara, Y., matsumoto, T., Inoue, K., Matsuda, D., Yoshiga, R., Yoshiya, K., ... Maehara, Y. (2017). Sarcopenia is a risk factor for cardiovascular events experienced by patients with critical limb ischemia. Journal of Vascular Surgery, 65(5), 1390-1397. https://doi.org/10.1016/j.jvs.2016.09.030

Sarcopenia is a risk factor for cardiovascular events experienced by patients with critical limb ischemia. / Matsubara, Yutaka; matsumoto, takuya; Inoue, Kentaro; Matsuda, Daisuke; Yoshiga, Ryosuke; Yoshiya, Keiji; Furuyama, Tadashi; Maehara, Yoshihiko.

:: Journal of Vascular Surgery, 巻 65, 番号 5, 01.05.2017, p. 1390-1397.

研究成果: ジャーナルへの寄稿記事

Matsubara, Y, matsumoto, T, Inoue, K, Matsuda, D, Yoshiga, R, Yoshiya, K, Furuyama, T & Maehara, Y 2017, 'Sarcopenia is a risk factor for cardiovascular events experienced by patients with critical limb ischemia', Journal of Vascular Surgery, 巻. 65, 番号 5, pp. 1390-1397. https://doi.org/10.1016/j.jvs.2016.09.030
Matsubara, Yutaka ; matsumoto, takuya ; Inoue, Kentaro ; Matsuda, Daisuke ; Yoshiga, Ryosuke ; Yoshiya, Keiji ; Furuyama, Tadashi ; Maehara, Yoshihiko. / Sarcopenia is a risk factor for cardiovascular events experienced by patients with critical limb ischemia. :: Journal of Vascular Surgery. 2017 ; 巻 65, 番号 5. pp. 1390-1397.
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abstract = "Background Prognosis is poor for patients with critical limb ischemia (CLI), and the most frequent cause of death is cardiovascular disease. Low grip strength is a risk factor for cardiovascular events, and sarcopenia may be associated as well. Thus, we hypothesized that sarcopenia is a risk factor for cardiovascular events experienced by patients with CLI. If this is true and appropriate therapy becomes available, the prognosis of patients with CLI will improve with appropriate risk management strategies to prevent cardiovascular events. Therefore, the aim of this study was to verify this hypothesis. Methods We studied 114 patients who underwent revascularization and computed tomography between January 2002 and December 2012 in the Department of Surgery and Sciences at Kyushu University in Japan. Sarcopenia was defined as skeletal muscle area measured by L3-level computed tomography scan <114.0 cm2 and <89.8 cm2 for men and women, respectively. Clinical characteristics, cardiovascular event-free survival, <2-year death, causes of death, and effective treatments for sarcopenia were investigated. Results We identified 53 (46.5{\%}) patients with sarcopenia. Three-year cardiovascular event-free survival rates were 43.1{\%} and 91.2{\%} for patients with and without sarcopenia, respectively (P <.01). During follow-up, cardiovascular disease caused the deaths of 4 and 15 patients without and with sarcopenia (P <.01), respectively, and in particular, ischemic heart disease caused the deaths of 0 and 5 patients without or with sarcopenia (P <.05), respectively. Single antiplatelet therapy (SAPT; hazard ratio, 0.46; 95{\%} confidence interval, 0.24-0.82; P <.01) and statin therapy (hazard ratio, 0.38; 95{\%} confidence interval, 0.16-0.78; P <.01) were independent factors associated with improved cardiovascular event-free survival. Three-year cardiovascular event-free survival rates for patients with sarcopenia who received SAPT, dual antiplatelet therapies, and no antiplatelet therapy were 75.3{\%}, 21.1{\%}, and 29.5{\%}, respectively (P <.01). Conclusions Sarcopenia is a risk factor for worse cardiovascular event-free survival, and SAPT and statin therapy reduced this risk for patients with CLI. Furthermore, SAPT but not dual antiplatelet therapy increased cardiovascular event-free survival in patients with sarcopenia.",
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AU - Matsubara, Yutaka

AU - matsumoto, takuya

AU - Inoue, Kentaro

AU - Matsuda, Daisuke

AU - Yoshiga, Ryosuke

AU - Yoshiya, Keiji

AU - Furuyama, Tadashi

AU - Maehara, Yoshihiko

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N2 - Background Prognosis is poor for patients with critical limb ischemia (CLI), and the most frequent cause of death is cardiovascular disease. Low grip strength is a risk factor for cardiovascular events, and sarcopenia may be associated as well. Thus, we hypothesized that sarcopenia is a risk factor for cardiovascular events experienced by patients with CLI. If this is true and appropriate therapy becomes available, the prognosis of patients with CLI will improve with appropriate risk management strategies to prevent cardiovascular events. Therefore, the aim of this study was to verify this hypothesis. Methods We studied 114 patients who underwent revascularization and computed tomography between January 2002 and December 2012 in the Department of Surgery and Sciences at Kyushu University in Japan. Sarcopenia was defined as skeletal muscle area measured by L3-level computed tomography scan <114.0 cm2 and <89.8 cm2 for men and women, respectively. Clinical characteristics, cardiovascular event-free survival, <2-year death, causes of death, and effective treatments for sarcopenia were investigated. Results We identified 53 (46.5%) patients with sarcopenia. Three-year cardiovascular event-free survival rates were 43.1% and 91.2% for patients with and without sarcopenia, respectively (P <.01). During follow-up, cardiovascular disease caused the deaths of 4 and 15 patients without and with sarcopenia (P <.01), respectively, and in particular, ischemic heart disease caused the deaths of 0 and 5 patients without or with sarcopenia (P <.05), respectively. Single antiplatelet therapy (SAPT; hazard ratio, 0.46; 95% confidence interval, 0.24-0.82; P <.01) and statin therapy (hazard ratio, 0.38; 95% confidence interval, 0.16-0.78; P <.01) were independent factors associated with improved cardiovascular event-free survival. Three-year cardiovascular event-free survival rates for patients with sarcopenia who received SAPT, dual antiplatelet therapies, and no antiplatelet therapy were 75.3%, 21.1%, and 29.5%, respectively (P <.01). Conclusions Sarcopenia is a risk factor for worse cardiovascular event-free survival, and SAPT and statin therapy reduced this risk for patients with CLI. Furthermore, SAPT but not dual antiplatelet therapy increased cardiovascular event-free survival in patients with sarcopenia.

AB - Background Prognosis is poor for patients with critical limb ischemia (CLI), and the most frequent cause of death is cardiovascular disease. Low grip strength is a risk factor for cardiovascular events, and sarcopenia may be associated as well. Thus, we hypothesized that sarcopenia is a risk factor for cardiovascular events experienced by patients with CLI. If this is true and appropriate therapy becomes available, the prognosis of patients with CLI will improve with appropriate risk management strategies to prevent cardiovascular events. Therefore, the aim of this study was to verify this hypothesis. Methods We studied 114 patients who underwent revascularization and computed tomography between January 2002 and December 2012 in the Department of Surgery and Sciences at Kyushu University in Japan. Sarcopenia was defined as skeletal muscle area measured by L3-level computed tomography scan <114.0 cm2 and <89.8 cm2 for men and women, respectively. Clinical characteristics, cardiovascular event-free survival, <2-year death, causes of death, and effective treatments for sarcopenia were investigated. Results We identified 53 (46.5%) patients with sarcopenia. Three-year cardiovascular event-free survival rates were 43.1% and 91.2% for patients with and without sarcopenia, respectively (P <.01). During follow-up, cardiovascular disease caused the deaths of 4 and 15 patients without and with sarcopenia (P <.01), respectively, and in particular, ischemic heart disease caused the deaths of 0 and 5 patients without or with sarcopenia (P <.05), respectively. Single antiplatelet therapy (SAPT; hazard ratio, 0.46; 95% confidence interval, 0.24-0.82; P <.01) and statin therapy (hazard ratio, 0.38; 95% confidence interval, 0.16-0.78; P <.01) were independent factors associated with improved cardiovascular event-free survival. Three-year cardiovascular event-free survival rates for patients with sarcopenia who received SAPT, dual antiplatelet therapies, and no antiplatelet therapy were 75.3%, 21.1%, and 29.5%, respectively (P <.01). Conclusions Sarcopenia is a risk factor for worse cardiovascular event-free survival, and SAPT and statin therapy reduced this risk for patients with CLI. Furthermore, SAPT but not dual antiplatelet therapy increased cardiovascular event-free survival in patients with sarcopenia.

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