Lower Muscle Strength and Increased Visceral Fat Associated With No-reflow and High Gensini Score in STEMI.
BACKGROUND
The impact of fat distribution, muscle mass, and muscle strength on no-reflow and severity of coronary artery disease in patients with ST-segment elevation myocardial infarction (STEMI) remains unclear.


OBJECTIVE
To investigate association between muscle strength and fat and muscle mass and severity of coronary atherosclerosis.


METHODS
We included 218 patients with STEMI who had undergone primary percutaneous coronary intervention. We evaluated the no-reflow phenomenon in infarct-related artery and calculated Gensini scores from initial angiograms as indicative of coronary atherosclerosis severity. The patients were divided into 2 groups as patients with no-reflow and with thrombolysis in myocardial infarction grade 3 flow and patients with low (<55) Gensini and with high (≥55) Gensini. Patients' total fat, muscle mass, visceral fat mass, and muscle strength were measured via body composition analyzer and handgrip dynamometer.


RESULTS
High Gensini patients had a greater body mass index (BMI) and lower handgrip strength and more visceral fat ( P = .05, P = .017, and P < .001, respectively). The patients with no-reflow had significantly lower handgrip strength and more visceral fat (both, P < .001). In multivariate regression analysis, visceral fat and handgrip strength were associated with high no-reflow rate and high Gensini scores in patients with STEMI ( P = .001, P = .014, P = .022, and P = .010; respectively).


CONCLUSIONS
Increased visceral fat and lower handgrip strength may be related to increased no-reflow rate and coronary plaque burden in STEMI. Visceral fat and muscle strength may be better prognostic markers than weight, BMI, total fat, and muscle mass in coronary artery disease.
1 Department of Cardiology, Bağcılar Education and Research Hospital, Istanbul, Turkey.
Burak
B
Ayça
1 Department of Cardiology, Bağcılar Education and Research Hospital, Istanbul, Turkey.
Didem
D
Kafadar
1 Department of Cardiology, Bağcılar Education and Research Hospital, Istanbul, Turkey.
Murat
M
Avsar
1 Department of Cardiology, Bağcılar Education and Research Hospital, Istanbul, Turkey.
I İlker
Iİ
Avci
2 Department of Cardiology, Muğla Sıtkı Koçman University, Medical School, Muğla, Turkey.
Fatih
F
Akın
1 Department of Cardiology, Bağcılar Education and Research Hospital, Istanbul, Turkey.
Ertugrul
E
Okuyan
1 Department of Cardiology, Bağcılar Education and Research Hospital, Istanbul, Turkey.
M Hakan
MH
Dinckal
D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D009203:Myocardial Infarction / Q000209:etiology* / Q000473:pathology; D054318:No-Reflow Phenomenon; D011446:Prospective Studies; D000072657:ST Elevation Myocardial Infarction / Q000209:etiology* / Q000473:pathology; D016896:Treatment Outcome
Gensini score; STEMI; muscle mass; muscle strength; no-reflow; visceral fat