Prognostic role of sarcopenia in heart failure patients

Cardiovasc Diabetol. 2025 Oct 28;24(1):411. doi: 10.1186/s12933-025-02949-5.

Abstract

Aim: Sarcopenia is common in heart failure (HF) patients; however, there are no data regarding the possible long-term prognostic role of sarcopenia in younger adults with chronic HF without malnutrition. The aim of this study was to examine the long-term prognostic role of sarcopenia in predicting major adverse cardiac events (MACE) in outpatients with chronic HF.

Methods: In the present retrospective analysis, 670 subjects with HF were enrolled. MACE (non-fatal ischemic stroke, non-fatal myocardial infarction, cardiac revascularization or coronary bypass surgery, and cardiovascular death) and total mortality occurrence were evaluated during a mean follow-up of 4.7 years.

Results: In the entire population, 340 patients were sarcopenic and 330 were not sarcopenic. In patients without sarcopenia, the observed MACE were 2.1 events/100 patient-year; while in the sarcopenic group there were 13.3 events/100 patient-year (p < 0.001). The multivariate analysis model confirmed that sarcopenia increase the risk of MACE by a factor of 8.6. Patients with sarcopenia had also a higher incidence of total mortality (p < 0.001) than patients without sarcopenia.

Conclusions: Patients with chronic HF that suffered from sarcopenia show a higher risk of MACE and total mortality, independently by their chronological age.

Keywords: Comorbidities; Heart failure; MACE; Sarcopenia.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Chronic Disease
  • Female
  • Heart Failure* / diagnosis
  • Heart Failure* / epidemiology
  • Heart Failure* / mortality
  • Heart Failure* / therapy
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Sarcopenia* / diagnosis
  • Sarcopenia* / epidemiology
  • Sarcopenia* / mortality
  • Sarcopenia* / physiopathology
  • Time Factors