Prognostic Usefulness of Arm and Calf Circumference in Patients ≥65 Years of Age With Cardiovascular Disease.
Current diagnostic criteria for sarcopenia require measurement of muscle function (MF) and muscle mass. Mid upper arm circumference (AC) and calf circumference (CC) are currently used as metrics of muscle mass. 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 men) with CVD. We measured MF (gait speed and grip strength), AC, and CC before hospital discharge. The end point was all-cause mortality. During follow-up (median 1.63 years, interquartile range 2.09 years), 72 deaths occurred. Both high AC and high CC were associated with better outcome; however, only AC (adjusted hazard ratio per SD increase 0.56, 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.
Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan. Electronic address: k-kamiya@kitasato-u.ac.jp.
Kentaro
K
Kamiya
Department of Cardiovascular Medicine, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan; Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan.
Takashi
T
Masuda
Department of Cardiology, Kameda Medical Center, Chiba, Japan.
Yuya
Y
Matsue
Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan; Department of Cardiovascular Medicine, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan.
Nobuaki
N
Hamazaki
Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan.
Ryota
R
Matsuzawa
Department of Cardiovascular Medicine, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan.
Shinya
S
Tanaka
Department of Rehabilitation, Kitasato University Hospital, Sagamihara, Japan.
Kohei
K
Nozaki
Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan.
Emi
E
Maekawa
Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan.
Chiharu
C
Noda
Department of Cardiovascular Medicine, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan; Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan.
Minako
M
Yamaoka-Tojo
Department of Cardiovascular Medicine, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan; Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan.
Atsuhiko
A
Matsunaga
Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan.
Junya
J
Ako
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001132:Arm; D001837:Body Weights and Measures; D002318:Cardiovascular Diseases / Q000150:complications / Q000175:diagnosis* / Q000401:mortality; D005260:Female; D015577:Geriatric Assessment; D018737:Hand Strength; D006801:Humans; D007866:Leg; D008297:Male; D018482:Muscle, Skeletal; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies; D000072797:Walking Speed