AI Article Synopsis
- Patients with heart failure (HF) who have sarcopenia experience worse outcomes, and cardiac rehabilitation (CR) can improve event incidence, but its effects on sarcopenia are not well understood.
- A study assessed patients' sarcopenia status before and after outpatient CR, categorizing them into three groups: robust (no sarcopenia), improved (sarcopenia improved), and unimproved (sarcopenia persistent).
- Results showed that patients in the unimproved group had a significantly higher risk of all-cause death compared to the robust group, suggesting that improving sarcopenia status through CR is crucial for better prognosis in HF patients.
Article Abstract
Objectives: Sarcopenia in patients with heart failure (HF) is associated with poor prognosis. Cardiac rehabilitation (CR) decreases the incidence of adverse events in patients with HF. However, the clinical implications of improving sarcopenia status through CR remain unclear. This study investigated the relationship between the changes in sarcopenia status in patients with HF undergoing outpatient CR and the risk of mortality and adverse events.
Design: This was a retrospective cohort study of patients hospitalized at the Kitasato University Hospital Cardiovascular Center for the treatment of HF between January 2007 and December 2020.
Setting And Participants: Patients with HF whose sarcopenia status was assessed at hospital discharge and following at least 3 months of outpatient CR were included. Based on the sarcopenia status, all patients were divided into 3 groups: patients without sarcopenia at discharge (ie, robust), patients with sarcopenia at discharge but no sarcopenia following CR (ie, improved), and patients with sarcopenia at discharge and following CR (ie, unimproved).
Methods: Cox regression analysis was used to examine the risk of all-cause death associated with the 3 sarcopenia status groups.
Results: Of 546 patients with HF (median age: 70 years; male: 63.6%), 377 (69.0%), 54 (9.9%), and 115 (21.1%) were classified as robust, improved, and unimproved, respectively. Multivariate Cox regression analysis showed that the unimproved group had a significantly greater risk of all-cause death when compared to the robust group [hazard ratio (HR) 2.603, 95% CI 1.375-4.930, P = .004], but it did not differ from the improved group (HR 1.403, 95% CI 0.598-3.293, P = .43).
Conclusions And Implications: No improvement in sarcopenia status in patients with HF undergoing outpatient CR was associated with a higher risk of all-cause death. Sarcopenia may be an important target to improve the prognosis of patients with HF.
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| http://dx.doi.org/10.1016/j.jamda.2023.10.035 | DOI Listing |
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