title: Impact of Skeletal Muscle Mass on Long-Term Adverse Cardiovascular Outcomes in Patients With Chronic Kidney Disease.
abstract: Sarcopenia, defined as skeletal muscle loss and dysfunction, is attracting considerable attention as a novel risk factor for cardiovascular events. Although the loss of skeletal muscle is common in chronic kidney disease (CKD) patients, the relation between sarcopenia and cardiovascular events in CKD patients is not well defined. Therefore, we aimed to investigate the relation between skeletal muscle mass and major adverse cardiovascular events (MACE) in CKD patients. We enrolled 266 asymptomatic CKD patients (median estimated glomerular filtration rate: 36.7 ml/min/1.73 m2). To evaluate skeletal muscle mass, we used the psoas muscle mass index (PMI) calculated from noncontrast computed tomography. The patients were divided into 2 groups according to the cut-off value of PMI for MACE. There were significant differences in age and body mass index between the low and high PMI groups (median age: 73.5 vs 69.0 years, p = 0.002; median body mass index: 22.6 vs 24.2 kg/m2, p <0.001, respectively). During the follow-up period (median: 3.2 years), patients with low PMI had significantly higher risk of MACE than those with high PMI (31.7% and 11.2%, log-rank test, p <0.001). The Cox proportional hazard model showed that low PMI is an independent predictor of MACE in CKD patients (hazard ratio 3.98, 95% confidence interval 1.65 to 9.63, p = 0.0022). In conclusion, low skeletal muscle mass is an independent predictor of MACE in CKD patients. The assessment of skeletal muscle mass may be a valuable screening tool for predicting MACE in clinical practice.
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Harada
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan. Electronic address: susumusuzuki@med.nagoya-u.ac.jp.
authors.forename: Susumu
authors.initials: S
authors.lastname: Suzuki
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Ishii
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Toshijiro
authors.initials: T
authors.lastname: Aoki
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Kenshi
authors.initials: K
authors.lastname: Hirayama
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Shibata
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Negishi
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Sumi
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kawashima
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Kunimura
authors.affiliation: Department of Cardiology, Kariya Toyota General Hospital, Kariya, Japan.
authors.forename: Yusaku
authors.initials: Y
authors.lastname: Shimbo
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Tatami
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Toshiki
authors.initials: T
authors.lastname: Kawamiya
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Dai
authors.initials: D
authors.lastname: Yamamoto
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan; Department of CKD Initiatives Internal Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Ryota
authors.initials: R
authors.lastname: Morimoto
authors.affiliation: Department of CKD Initiatives Internal Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Yasuda
authors.affiliation: Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Toyoaki
authors.initials: T
authors.lastname: Murohara
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D005919:Glomerular Filtration Rate; D006333:Heart Failure / Q000453:epidemiology*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology*; D009204:Myocardial Revascularization / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D016658:Psoas Muscles / Q000000981:diagnostic imaging; D051436:Renal Insufficiency, Chronic / Q000453:epidemiology*; D055948:Sarcopenia / Q000453:epidemiology*; D012907:Smoking / Q000453:epidemiology; D014057:Tomography, X-Ray Computed
chemical_list: D002097:C-Reactive Protein