Sarcopenia as a Prognostic Factor in Peripheral Arterial Disease: Descriptive Review

Autores da FMUP

• João Pedro Melo Marques Pinho Ferreira

  Autor

• Angela Maria Veloso Guimarães Carneiro

  Autor

• Armando Amilcar Pires Mansilha Rodrigues De Almeida

  Autor

Participantes de fora da FMUP

• Cunha, P
• Vila, I
• Cunha, C
• Silva, C
• Longatto, A
• Mesquita, A
• Cotter, J
• Correia Neves, M

Unidades de investigação

• Cirurgia e Fisiologia

• Laboratório Associado RISE- Rede de Investigação em Saúde

  

  Investigador

  Fernando Carlos De Landér Schmitt

• RISE-Health

  

  Investigador

  Fernando Carlos De Landér Schmitt

Abstract

Background: Determine the influence of sarcopenia on the prognosis of peripheral arterial disease (PAD). Methods: A systematic search of the PubMed and Cochrane Library databases was performed with the keywords and medical subject heading (MesH): "muscle, skeletal", "sarcopenia", "prognosis", "duration of stay", "death", "mortality", "patient readmission", "length of stay", "peripheral arterial disease", "intermittent claudication" and "critical limb ischemia". Papers published from January 2010 to October 2020 in English, French, Spanish and Portuguese were eligible for inclusion. The primary outcome was overall survival. Secondary outcomes included postoperative complications, amputation, length of hospital stay and hospital readmission. Results: Of 1071 papers, 8 articles and 1511 patients were included (68.96% male, mean age 71.83 years). Five papers found an inverse relationship between SM area and mortality. Matsubara (2015) found that the 5-year overall survival rates were lower for patients with sarcopenia (23.5% +/- 0.18% vs 77.5% +/- 0.09% P = 0.001). Matsubara (2016) registered 3-year cardiovascular event-free survival rates of 43.1% and 91.2% for patients with and without sarcopenia (P < 0.01). Juszczak (2018) found that survival was lower in patients with reduced total psoas area. Taniguchi (2019) found that 3-year overall survival rate was 60% for patients with sarcopenia and 87% for patients without sarcopenia (P < 0.05). Shimazoe (2019) concluded sarcopenia was a significant predictor of overall survival. Distinctly, Nyers (2017) concluded that higher ratio bilateral psoas area to L4 vertebral body was associated with an increased risk of death. Two other studies analyzed other characteristics of the SM (density and strength). McDermott (2012) and found that lower calf muscle density and strength were associated with an increase in mortality. Sugai (2019) concluded that patients with major cardiovascular and limb events had a lower SM density. Conclusions: Lower SM area and mass seem to be associated with a higher mortality in PAD patients.

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Keywords

• SKELETAL-MUSCLE; GRIP STRENGTH; SURVIVAL; FRAILTY; INDEX; INFLAMMATION; MORBIDITY; MORTALITY; TRAUMA; IMPACT