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

Joana Margarida Magalhães Ferreira; Pedro Cunha; Alexandre Carneiro; Isabel Vila; Cristina Cunha; Cristina Silva; Adhemar Longatto-Filho; Amílcar Mesquita; Jorge Cotter; Armando Mansilha; Margarida Correia-Neves

doi:10.1016/j.avsg.2021.01.076

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

Ann Vasc Surg. 2021 Jul:74:460-474. doi: 10.1016/j.avsg.2021.01.076. Epub 2021 Feb 5.

Affiliations

¹ Vascular Surgery Department, Hospital da Senhora da Oliveira, Guimarães, Portugal; Life and Health Science Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal. Electronic address: joana222@gmail.com.
² Life and Health Science Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal; Medicine Department, Hospital da Senhora da Oliveira, Guimarães, Portugal; Internal Medicine Department, Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk, Hospital da Senhora da Oliveira, Guimarães, Portugal.
³ Radiology Department, ULSAM, Viana do Castelo, Portugal.
⁴ Life and Health Science Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal; Internal Medicine Department, Center for the Research and Treatment of Arterial Hypertension and Cardiovascular Risk, Hospital da Senhora da Oliveira, Guimarães, Portugal; Department of Pathology (LIM-14), University of São Paulo School of Medicine, São Paulo, Brazil; Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, São Paulo, Brazil.
⁵ Vascular Surgery Department, Hospital da Senhora da Oliveira, Guimarães, Portugal.
⁶ Faculdade de Medicina da Universidade do Porto, Porto, Portugal; Vascular Surgery Department, Hospital de São João, Porto, Portugal.
⁷ Life and Health Science Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal; ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal.

PMID: 33556522
DOI: 10.1016/j.avsg.2021.01.076

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 post-operative 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.

Publication types

Review

MeSH terms

Female
Humans
Length of Stay
Male
Peripheral Arterial Disease / complications*
Peripheral Arterial Disease / mortality
Prognosis
Sarcopenia / complications*
Survival Rate