Department of Radiology, Bursa Yuksek İhtisas Training and Research Hospital, Health Sciences University, Bursa, Turkey.
Department of Cardiology, Bursa City Hospital, University of Health Sciences, Bursa, Turkey.
Angiology. 2024 Aug;75(7):651-657. doi: 10.1177/00033197231187230. Epub 2023 Jun 30.
Sarcopenia is accepted as an indicator of subclinical atherosclerosis. However, its effects on clinical coronary atherosclerotic burden and lesion complexity and major adverse cardiovascular events (MACE) in elderly patients with non-ST elevation myocardial infarction (NSTEMI) are unknown. Therefore, we evaluated these possible effects. Coronary artery disease (CAD) burden and complexity were assessed using the Gensini and TAXus and cardiac surgery (SYNTAX) score, respectively. MACE involving nonfatal myocardial infarction, rehospitalization, ischemic stroke, and total mortality were evaluated after 1 year of the index NSTEMI event. The study included 240 elderly patients; of these, 60 (25%) patients had sarcopenia. The SYNTAX score and Gensini score were similar in both groups (16.8 ± 8.7 vs 17.3 ± 9.2, = .63 and 67.7 ± 43.9 vs 73.9 ± 45.5, = .31, respectively). The total MACE rate was significantly higher in patients with sarcopenia than in those without sarcopenia (31.7 vs 14.4%, = .003). In the multivariate model, age [odds ratio (OR) 1.112, 95% CI: 1.006-1.228, = .04)], ejection fraction (OR: .923, 95% CI: .897-.951, < .001), and sarcopenia (OR: 2.262, 95% CI: 1.039-4.924, = .04) were independently associated with MACE. Sarcopenia was independently associated with MACE but not with CAD burden or complexity in elderly patients with NSTEMI.
肌肉减少症被认为是亚临床动脉粥样硬化的一个指标。然而，其对非 ST 段抬高型心肌梗死（NSTEMI）老年患者的临床冠状动脉粥样硬化负担和病变复杂性以及主要不良心血管事件（MACE）的影响尚不清楚。因此，我们评估了这些可能的影响。使用 Gensini 和 TAXus 评分分别评估冠状动脉疾病（CAD）负担和复杂性。在 NSTEMI 事件发生 1 年后，评估了非致命性心肌梗死、再住院、缺血性卒中和全因死亡率等 MACE。该研究纳入了 240 名老年患者，其中 60 名（25%）患者存在肌肉减少症。两组患者的 SYNTAX 评分和 Gensini 评分相似（16.8 ± 8.7 vs 17.3 ± 9.2， =.63 和 67.7 ± 43.9 vs 73.9 ± 45.5， =.31）。肌肉减少症患者的总 MACE 发生率明显高于无肌肉减少症患者（31.7% vs 14.4%， =.003）。在多变量模型中，年龄[比值比（OR）1.112，95%可信区间（CI）：1.006-1.228， =.04]、射血分数（OR：.923，95% CI：.897-.951， <.001）和肌肉减少症（OR：2.262，95% CI：1.039-4.924， =.04）与 MACE 独立相关。肌肉减少症与 MACE 独立相关，但与 NSTEMI 老年患者的 CAD 负担或复杂性无关。
