Prognostic Usefulness of Arm and Calf Circumference in Patients ≥65 Years of Age with Cardiovascular Disease

• Published in: The American journal of cardiology 2017-01, Vol.119 (2), p.186-191
• Main Authors: Kamiya, Kentaro, PT, PhD, Masuda, Takashi, MD, PhD, Matsue, Yuya, MD PhD, Hamazaki, Nobuaki, PT, MSc, Matsuzawa, Ryota, PT, PhD, Tanaka, Shinya, PT, MSc, Nozaki, Kohei, PT, MSc, Maekawa, Emi, MD, PhD, Noda, Chiharu, MD, PhD, Yamaoka-Tojo, Minako, MD, PhD, Matsunaga, Atsuhiko, PT, PhD, Ako, Junya, MD, PhD
• Format: Article
• Language: English
• Subjects: Acute coronary syndromes; Age; Age Factors; Aged; Aged, 80 and over; Aging; Ankle; Arm; Arm circumference; Assaying; Biochemistry; Biometrics; Body composition; Body fat; Body mass; Body mass index; Body weight; Body Weights and Measures; Brain natriuretic peptide; Cardiac muscle; Cardiovascular; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - complications; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - mortality; Computed tomography; Coronary artery disease; Correlation; Creatinine; Death; Demographic variables; Diabetes mellitus; Drugs; Dual energy X-ray absorptiometry; Elbow; Female; Filtration; Forecasting; Geriatric Assessment; Guidelines; Hand Strength; Heart diseases; Heart failure; Heart rate; Hum; Humans; Humerus; Hypertension; Incidence; Leg; Liver; Liver transplantation; Longevity; Male; Mathematical models; Medical prognosis; Mortality; Muscle, Skeletal; Muscles; Musculoskeletal system; Plotting; Prediction models; Predictive Value of Tests; Prognosis; Regression analysis; Retrospective Studies; Risk; ROC Curve; Sarcopenia; Spline functions; Statistics; Survival; Transplantation; Transplants & implants; Variance analysis; Ventricle; Walking Speed
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2016.09.040

Abstract Current diagnostic criteria for sarcopenia require measurement of muscle function (MF) and muscle mass (MM). Mid-upper arm circumference (AC) and calf circumference (CC) are currently used as metrics of MM. This study was performed to compare the prognostic predictive capabilities of AC and CC in older patients with cardiovascular disease (CVD). The study population consisted of 599 admitted patients aged > 65 years (74.8 ± 6.3 years, 392 males) with CVD. We measured MF (gait speed and grip strength), AC, and CC before hospital discharge. The endpoint was all-cause mortality. During follow-up (median 1.63 years, IQR 2.1 years), 72 deaths occurred. Both high AC and high CC were associated with better outcome; however, only AC (adjusted hazard ratio per SD increase: 0.54, p = 0.023), but not CC (adjusted hazard ratio per SD increase: 0.91, p = 0.696), showed significant independent prognostic capability after adjusting for other prognostic factors. Moreover, adding AC to MF (0.71 vs. 0.62, p = 0.005) but not CC to MF (0.67 vs. 0.62, p = 0.188) significantly increased the area under the curve on receiver-operating characteristic curve. In conclusion, a high AC, but not CC, was an independent predictor of survival and could be a readily available and simple metric for risk stratification in older patients with CVD.