Lower Muscle Strength and Increased Visceral Fat Associated With No-reflow and High Gensini Score in STEMI. (May 2017)

• Record Type: Journal Article
• Authors: Ayça, Burak; Kafadar, Didem; Avsar, Murat; Avci, İ. İlker; Akın, Fatih; Okuyan, Ertugrul; Dinckal, M. Hakan
• Is Part Of: Clinical and applied thrombosis/hemostasis. Volume 23:Number 4(2017)
• Page Start: 367
• Page End: 373
• Publication Date: 2017-05
• Subjects: visceral fat -- muscle mass -- muscle strength -- Gensini score -- no-reflow -- STEMI; Hemostasis -- Periodicals; Thrombosis -- Periodicals; 616.13
• DOI: 10.1177/1076029615613159
• Languages: English
• ISSNs: 1076-0296

Abstract

Background: The impact of fat distribution, muscle mass, and muscle strength on no-reflow and severity of coronary artery disease in patients with ST-segment elevation myocardial infarction (STEMI) remains unclear. Objective: To investigate association between muscle strength and fat and muscle mass and severity of coronary atherosclerosis. Methods: We included 218 patients with STEMI who had undergone primary percutaneous coronary intervention. We evaluated the no-reflow phenomenon in infarct-related artery and calculated Gensini scores from initial angiograms as indicative of coronary atherosclerosis severity. The patients were divided into 2 groups as patients with no-reflow and with thrombolysis in myocardial infarction grade 3 flow and patients with low (<55) Gensini and with high (≥55) Gensini. Patients' total fat, muscle mass, visceral fat mass, and muscle strength were measured via body composition analyzer and handgrip dynamometer. Results: High Gensini patients had a greater body mass index (BMI) and lower handgrip strength and more visceral fat ( P = .05, P = .017, and P < .001, respectively). The patients with no-reflow had significantly lower handgrip strength and more visceral fat (both, P < .001). In multivariate regression analysis, visceral fat and handgrip strength were associated with high no-reflow rate and high Gensini scores in patients with STEMI ( P = .001, P = .014, P = .022, and P = .010; respectively). Conclusion: Increased visceral fat and lower handgrip strength may be related to increased no-reflow rate and coronary plaque burden in STEMI. Visceral fat and muscle strength may be better prognostic markers than weight, BMI, total fat, and muscle mass in coronary artery disease.