Non-invasive testing for sarcopenia predicts future cardiovascular events in patients with chronic kidney disease. (1st October 2018)

• Record Type: Journal Article
• Authors: Hanatani, Shinsuke; Izumiya, Yasuhiro; Onoue, Yoshiro; Tanaka, Tomoko; Yamamoto, Masahiro; Ishida, Toshifumi; Yamamura, Satoru; Kimura, Yuichi; Araki, Satoshi; Arima, Yuichiro; Nakamura, Taishi; Fujisue, Koichiro; Takashio, Seiji; Sueta, Daisuke; Sakamoto, Kenji; Yamamoto, Eiichiro; Kojima, Sunao; Kaikita, Koichi; Tsujita, Kenichi
• Is Part Of: International journal of cardiology. Volume 268(2018)
• Page Start: 216
• Page End: 221
• Publication Date: 2018-10-01
• Subjects: Sarcopenia -- Chronic kidney disease -- Heart failure -- Cardiovascular event; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2018.03.064
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: Sarcopenia is frequently observed and associated with poor outcomes in patients with chronic kidney disease (CKD). A simple screening test for sarcopenia using age, grip strength, and calf circumference was recently developed. However, the clinical utility of this sarcopenia score in patients with CKD remains unclear. Methods and results: We calculated the sarcopenia score of 265 patients with CKD and followed the patients for cardiovascular events. The endpoint of this study was the composite of cardiovascular hospitalization and total mortality. We divided all participants into high ( n = 166) and low ( n = 99) sarcopenia score groups using a simple scoring system. Patients in the high sarcopenia score group showed significantly higher plasma B-type natriuretic peptide (BNP) levels than those in the low sarcopenia score group (median: 103.1, interquartile range: 46.3–310.0 vs. 46.7, 18.0–91.8 pg/mL; p < 0.0001). The Kaplan–Meier curve revealed that the risk of cardiovascular events was significantly greater in the high sarcopenia score group (log-rank test: p < 0.0001), even after potential confounding factors were corrected using propensity score matching. Multivariate Cox hazard analysis identified a high sarcopenia score (hazard ratio: 3.04, 95% confidence interval: 1.45–6.38, p = 0.003) as an independent predictor of the primary endpoints. Furthermore, the combination of a high sarcopenia score and high BNP level identified patients with a significantly higher probability of future events ( p < 0.0001). Conclusions: This study demonstrates that this simple screening score for sarcopenia could be a useful tool for estimating the future adverse event risk in patients with CKD. Highlights: Easily available sarcopenia screening predicts cardiovascular events in CKD patients. Sarcopenia score is associated with future events even after propensity score match. Simple sarcopenia score provides incremental prognostic value to BNP.