Impact of Skeletal Muscle Mass on Long-Term Adverse Cardiovascular Outcomes in Patients With Chronic Kidney Disease

Kazuhiro Harada, Susumu Suzuki, Hideki Ishii, Toshijiro Aoki, Kenshi Hirayama, Yohei Shibata, Yosuke Negishi, Takuya Sumi, Kazuhiro Kawashima, Ayako Kunimura, Yusaku Shimbo, Yosuke Tatami, Toshiki Kawamiya, Dai Yamamoto, Ryota Morimoto, Yoshinari Yasuda, Toyoaki Murohara

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Sarcopenia, defined as skeletal muscle loss and dysfunction, is attracting considerable attention as a novel risk factor for cardiovascular events. Although the loss of skeletal muscle is common in chronic kidney disease (CKD) patients, the relation between sarcopenia and cardiovascular events in CKD patients is not well defined. Therefore, we aimed to investigate the relation between skeletal muscle mass and major adverse cardiovascular events (MACE) in CKD patients. We enrolled 266 asymptomatic CKD patients (median estimated glomerular filtration rate: 36.7 ml/min/1.73 m2). To evaluate skeletal muscle mass, we used the psoas muscle mass index (PMI) calculated from noncontrast computed tomography. The patients were divided into 2 groups according to the cut-off value of PMI for MACE. There were significant differences in age and body mass index between the low and high PMI groups (median age: 73.5 vs 69.0 years, p = 0.002; median body mass index: 22.6 vs 24.2 kg/m2, p <0.001, respectively). During the follow-up period (median: 3.2 years), patients with low PMI had significantly higher risk of MACE than those with high PMI (31.7% and 11.2%, log-rank test, p <0.001). The Cox proportional hazard model showed that low PMI is an independent predictor of MACE in CKD patients (hazard ratio 3.98, 95% confidence interval 1.65 to 9.63, p = 0.0022). In conclusion, low skeletal muscle mass is an independent predictor of MACE in CKD patients. The assessment of skeletal muscle mass may be a valuable screening tool for predicting MACE in clinical practice.

Original languageEnglish
Pages (from-to)1275-1280
Number of pages6
JournalAmerican Journal of Cardiology
Volume119
Issue number8
DOIs
Publication statusPublished - 15-04-2017
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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    Harada, K., Suzuki, S., Ishii, H., Aoki, T., Hirayama, K., Shibata, Y., Negishi, Y., Sumi, T., Kawashima, K., Kunimura, A., Shimbo, Y., Tatami, Y., Kawamiya, T., Yamamoto, D., Morimoto, R., Yasuda, Y., & Murohara, T. (2017). Impact of Skeletal Muscle Mass on Long-Term Adverse Cardiovascular Outcomes in Patients With Chronic Kidney Disease. American Journal of Cardiology, 119(8), 1275-1280. https://doi.org/10.1016/j.amjcard.2017.01.003