Harada Haruhito, Nishiyama Yasuhiro, Niiyama Hiroshi, Katoh Atsushi, Kai Hisashi
Department of Cardiology, Kurume University Medical Center, Kurume, Japan.
J Clin Pharm Ther. 2022 Jan;47(1):89-96. doi: 10.1111/jcpt.13540. Epub 2021 Oct 20.
Reduction in skeletal muscle mass is the most important component in diagnosing sarcopenia. Ageing and chronic heart failure due to cardiovascular diseases (CVDs) accelerate the reduction of skeletal muscles. However, there are no currently available drugs that are effective for sarcopenia. The purpose of this study was to explore the association between prescribed medications and skeletal muscle mass in patients with CVD.
This was a single-centre, retrospective, cross-sectional study. The subjects were 636 inpatients with CVD who took prescribed medicines for at least 4 weeks at the time of admission. Skeletal muscle volume was assessed using a bioelectrical impedance assay.
Single regression analysis showed that 10 and 3 medications were positively and negatively associated with skeletal muscle index (SMI), respectively. Stepwise multivariate regression analysis revealed that angiotensin II receptor blocker (ARB)/statin combination, dipeptidyl peptidase-4 inhibitor, and antihyperuricemic agents were positively associated with SMI while diuretics and antiarrhythmic agents were negatively associated with SMI. After adjustment using propensity score matching, the SMI was found to be significantly higher in ARB/statin combination users than in non-users.
Combination use of ARB/statin was associated with a higher SMI in patients with CVD. A future randomised, controlled trial is warranted to determine whether the ARB/statin combination will increase the SMI and prevent sarcopenia in patients with CVD.
骨骼肌质量减少是诊断肌肉减少症的最重要组成部分。衰老和心血管疾病(CVD)导致的慢性心力衰竭会加速骨骼肌的减少。然而,目前尚无对肌肉减少症有效的药物。本研究的目的是探讨CVD患者处方药物与骨骼肌质量之间的关联。
这是一项单中心、回顾性横断面研究。研究对象为636例CVD住院患者,他们在入院时已服用处方药物至少4周。使用生物电阻抗分析法评估骨骼肌体积。
单因素回归分析显示,分别有10种和3种药物与骨骼肌指数(SMI)呈正相关和负相关。逐步多因素回归分析显示,血管紧张素II受体阻滞剂(ARB)/他汀类药物联合使用、二肽基肽酶-4抑制剂和抗高尿酸血症药物与SMI呈正相关,而利尿剂和抗心律失常药物与SMI呈负相关。使用倾向得分匹配法进行调整后,发现ARB/他汀类药物联合使用者的SMI显著高于非使用者。
ARB/他汀类药物联合使用与CVD患者较高的SMI相关。未来有必要进行一项随机对照试验,以确定ARB/他汀类药物联合使用是否会增加CVD患者的SMI并预防肌肉减少症。