Prognostic Impact and Prevalence of Cachexia in Patients With Heart Failure: A Systematic Review and Meta-Analysis.

IF 8.9 1区医学

Journal of Cachexia, Sarcopenia and Muscle Pub Date : 2024-10-30 DOI:10.1002/jcsm.13596

Konstantinos Prokopidis, Krzysztof Irlik, Mirela Hendel, Julia Piaśnik, Gregory Y H Lip, Katarzyna Nabrdalik

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Abstract

Background: Cachexia, defined as the combination of weight loss, weakness, fatigue, anorexia and abnormal biochemical markers based on Evans' criteria, is known to exacerbate the prognosis of heart failure (HF) patients. This systematic review and meta-analysis investigates the prognostic impact and prevalence of cachexia, as defined by Evans' criteria, in patients with HF.

Methods: PubMed, Cochrane Library, Scopus and Web of Science were searched from inception until December 2023, including HF patients for whom the Evans' criteria were applied to explore the prevalence and prognostic impact of cachexia. This study employed a meta-analyses using the random-effects model and inverse-variance method that was adhered to the revised 2020 PRISMA guidelines for systematic reviews and meta-analyses (CRD42023446443).

Results: Six prospective or retrospective studies of 2252 patients with HF were included, whereby all-cause mortality was significantly greater in patients with cachexia with low heterogeneity among studies (HR: 1.60, 95% CI 1.31-1.95, p < 0.001; I² = 0%). For the studies that used full, uniformly defined Evans' criteria, among 1844 patients, mortality remained greater in patients with cachexia (HR: 1.58, 95% CI 1.27-1.97, p < 0.001; I² = 0%). In a subgroup analysis among 1714 of HF with reduced ejection fraction, the results were consistent (HR: 1.57, 95% CI 1.28-1.92, p < 0.001; I² = 0%). Additionally, 10 studies comprising 2862 patients indicated a 31% risk of cachexia in HF (95% CI 21-43%, I² = 94%).

Conclusions: Cachexia is an independent predictor for increased all-cause mortality among patients with HF with a notable prevalence of 31%. Interventions aiding in improving fatigue, anorexia and exercise capacity could help improve the quality of life of this clinical population.

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心力衰竭患者恶病质的预后影响和患病率：系统综述与元分析》。

背景：根据埃文斯标准，恶病质是指体重减轻、虚弱、疲劳、厌食和生化指标异常的综合表现，众所周知，恶病质会加重心力衰竭（HF）患者的预后。本系统综述和荟萃分析调查了埃文斯标准定义的恶病质对心力衰竭患者预后的影响和患病率：方法：对 PubMed、Cochrane Library、Scopus 和 Web of Science 进行了检索，检索时间从开始至 2023 年 12 月，检索对象包括采用埃文斯标准的高血压患者，以探讨恶病质的患病率和对预后的影响。本研究采用随机效应模型和逆方差法进行荟萃分析，并遵守修订后的2020年系统综述和荟萃分析PRISMA指南（CRD42023446443）：结果：共纳入了6项前瞻性或回顾性研究，涉及2252名心房颤动患者，其中恶病质患者的全因死亡率显著升高，但各研究间的异质性较低（HR：1.60，95% CI 1.31-1.95，P 2 = 0%）。在使用完整、统一定义的埃文斯标准的研究中，1844 名患者中，恶病质患者的死亡率仍然更高（HR：1.58，95% CI 1.27-1.97，P 2 = 0%）。在对 1714 例射血分数降低的心房颤动患者进行的亚组分析中，结果一致（HR：1.57，95% CI 1.28-1.92，P 2 = 0%）。此外，包括2862名患者在内的10项研究表明，HF患者出现恶病质的风险为31%（95% CI 21-43%，I2 = 94%）：结论：恶病质是心房颤动患者全因死亡率增加的独立预测因素，发病率高达 31%。改善疲劳、厌食和运动能力的干预措施有助于提高这类临床人群的生活质量。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cachexia, Sarcopenia and Muscle Medicine-Orthopedics and Sports Medicine

自引率

12.40%

发文量

期刊介绍： The Journal of Cachexia, Sarcopenia, and Muscle is a prestigious, peer-reviewed international publication committed to disseminating research and clinical insights pertaining to cachexia, sarcopenia, body composition, and the physiological and pathophysiological alterations occurring throughout the lifespan and in various illnesses across the spectrum of life sciences. This journal serves as a valuable resource for physicians, biochemists, biologists, dieticians, pharmacologists, and students alike.