High “sarcopenia index” reduce all-cause mortality in patients with acute myocardial infarction

IF 7.4 2区医学 Q1 NUTRITION & DIETETICS

Clinical nutrition Pub Date : 2025-09-24 DOI:10.1016/j.clnu.2025.09.009

Hui Pan , C. Yu Dong , Z. Cheng Yang , Y. Bin Xi , He Lin , J. Lu Zhu , X. Wen Wang , H. Jie Zhan , Z. Hao Wang

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引用次数: 0

Abstract

Background

The product of serum creatinine and cystatin C-based estimated glomerular filtration rate (hereinafter referred to as “Cr × eGFRcys”), serving as the formula for the Sarcopenia Index (SI), could be regarded as a representative marker for sarcopenia. However, no studies have investigated whether Cr × eGFRcys can predict all-cause mortality in elderly patients with acute myocardial infraction (AMI).

Aim

To investigate the association between Cr × eGFRcys and all-cause mortality risk in elderly AMI patients.

Methods

We conducted a retrospective cohort analysis of 500 elderly (≥65 years) AMI patients. Participants were stratified into high and low Cr × eGFRcys groups using the optimal cut-off determined by receiver operating characteristic (ROC) analysis, with all-cause mortality as the primary endpoint. Kaplan–Meier (hereinafter referred to as “K-M”) survival curves assessed survival differences (log-rank test). Multivariable Cox proportional hazards models evaluated the independent association of Cr × eGFRcys (as continuous, categorical, or per-standard deviation increase) with mortality. The added predictive value beyond conventional risk factors was assessed through C-statistics, continuous net reclassification improvement (NRI), and integrated discrimination improvement (IDI).

Result

Survival analysis revealed significantly better outcomes in the high Cr × eGFRcys group compared to the low group (log-rank p < 0.0001). Inclusion of Cr × eGFRcys significantly enhanced the predictive accuracy of the baseline risk model for all-cause mortality: NRI = 0.43 (95 % CI: 0.17–0.61, p < 0.01), IDI = 0.04 (95 % CI: 0.01–0.08, p = 0.02), and C-index = 0.93 (95 % CI: 0.90–0.96), all with p < 0.05.

Conclusion

Cr × eGFRcys was significantly associated with all-cause mortality, and the optimal cut-off value for predicting all-cause mortality was 53.56, suggesting that Cr × eGFRcys may serve as a valid marker of all-cause mortality in elderly patients with AMI.

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高“肌肉减少指数”降低急性心肌梗死患者的全因死亡率

基于血清肌酐和胱抑素c估算肾小球滤过率的乘积（以下简称“Cr × eGFRcys”）作为肌少症指数（Sarcopenia Index， SI）的计算公式，可视为肌少症的代表性标志物。然而，Cr × eGFRcys是否能预测老年急性心肌梗死（AMI）患者的全因死亡率尚无研究。目的探讨Cr × egfrys与老年AMI患者全因死亡风险的关系。方法对500例老年（≥65岁）AMI患者进行回顾性队列分析。采用受试者工作特征（ROC）分析确定的最佳截止值，以全因死亡率为主要终点，将受试者分为高Cr × eGFRcys组和低Cr × eGFRcys组。Kaplan-Meier（以下简称“K-M”）生存曲线评估生存差异（log-rank检验）。多变量Cox比例风险模型评估了Cr × egfrys（连续、分类或每标准偏差增加）与死亡率的独立关联。通过c统计、连续净重分类改善（NRI）和综合判别改善（IDI）评估常规危险因素之外的附加预测价值。结果生存分析显示，高Cr × eGFRcys组的预后明显优于低Cr × eGFRcys组（log-rank p < 0.0001）。纳入Cr × eGFRcys显著提高了全因死亡率基线风险模型的预测准确性：NRI = 0.43 (95% CI: 0.17-0.61, p < 0.01), IDI = 0.04 (95% CI: 0.01 - 0.08, p = 0.02), C-index = 0.93 (95% CI: 0.90-0.96)，均p <； 0.05。结论Cr × eGFRcys与全因死亡率有显著相关性，预测全因死亡率的最佳临界值为53.56，提示Cr × eGFRcys可作为老年AMI患者全因死亡率的有效指标。

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

Clinical nutrition 医学-营养学

CiteScore

14.10

自引率

6.30%

发文量

356

审稿时长

28 days

期刊介绍： Clinical Nutrition, the official journal of ESPEN, The European Society for Clinical Nutrition and Metabolism, is an international journal providing essential scientific information on nutritional and metabolic care and the relationship between nutrition and disease both in the setting of basic science and clinical practice. Published bi-monthly, each issue combines original articles and reviews providing an invaluable reference for any specialist concerned with these fields.