Sarcopenia prevalence high with HFrEF, predicts adverse outcomes
Sarcopenia significantly increases risk for adverse outcomes in adults with HF with reduced ejection fraction, including death and rehospitalization, as well as risk for falls and hospitalization, researchers reported.
“Although several recent clinical trials and reviews have attempted to evaluate the clinical outcomes and prevalence of sarcopenia in patients with HF, most of these studies are limited by the number of investigations and test size and have not accurately identified its prevalence and clinical outcome,” Xiufang Lin, MD, of the Center of Gerontology and Geriatrics/National Clinical Research Center for Geriatrics at West China Hospital, Sichuan University, and colleagues wrote in the study background. “However, exploring the clinical outcomes and prevalence of sarcopenia in patients with HF remains an important proposition, and a meta‐analysis with large sample size is urgently needed.”
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In a systematic review and meta-analysis, Lin and colleagues analyzed data from 21 observational studies with 68,556 adults with HF, published between 2015 and 2022. All studies examined the epidemiology of sarcopenia in adults with HF. Researchers calculated pooled prevalence of sarcopenia as well as pooled effect size of sarcopenia on HF outcomes.
The findings were published in Clinical Cardiology.
The combined prevalence of sarcopenia in patients with HF was 31%.
In subgroup analyses, the prevalence of sarcopenia in patients with HF was 35% in Asia; 31% in Europe; 25% in the Americas; 31% in people aged 65 years and older; 25% in people younger than 65 years; 28% for those with HFrEF and 18% for those with HF with preserved EF.
In a random-effects model, sarcopenia was associated with an increased risk for poor prognosis, with a pooled HR of 1.64 (95% CI, 1.2-2.25; P < .01). In subgroup analyses, sarcopenia in HF was mainly associated with increased risk for all-cause mortality (HR = 2.06; 95% CI, 1.52-2.8; P < .01) and hospitalization (HR = 1.52; 95% CI, 1.4-1.65; P < .01).
However, in analyses stratified by EF, sarcopenia was associated with poor outcomes in people with HFrEF, with a pooled HR of 2.77 (95% CI, 1.29-5.95; P = .01), but was not associated with poor outcomes for people with HFpEF (HR = 1.61; 95% CI, 0.82-3.16; P = .17).
“Our findings suggest that cardiovascular physicians should focus more on screening for sarcopenia, particularly on stratified screening based on age and type of HF, and promptly apply effective prevention programs such as resistance training to lower the prevalence of sarcopenia and the risk of poor prognosis,” the researchers wrote.
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