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Lower Muscle Strength and Increased Visceral Fat Associated With No-reflow and High Gensini Score in STEMI
Burak Ayça1, Didem Kafadar1, Murat Avsar1
11 Department of Cardiology, Bağcılar Education and Research Hospital, Istanbul, Turkey.
Insights
Increased visceral fat and lower muscle strength are linked to worse outcomes in ST-segment elevation myocardial infarction (STEMI). These factors may be better predictors of coronary artery disease severity than BMI or weight.
Area of Science:
- Cardiology
- Biomedical Science
- Clinical Research
Background:
- The relationship between body composition (fat distribution, muscle mass, and strength) and outcomes in ST-segment elevation myocardial infarction (STEMI) is not fully understood.
- Specifically, the impact on no-reflow phenomenon and coronary artery disease severity requires further investigation.
Purpose of the Study:
- To examine the association between muscle strength, fat mass, muscle mass, and the severity of coronary atherosclerosis in STEMI patients.
- To determine if body composition metrics can predict adverse outcomes post-myocardial infarction.
Main Methods:
- A study included 218 patients with STEMI undergoing primary percutaneous coronary intervention.
- Coronary atherosclerosis severity was assessed using Gensini scores, and the no-reflow phenomenon was evaluated.
- Body composition (total fat, muscle mass, visceral fat) and muscle strength (handgrip) were measured.
Main Results:
- Patients with higher Gensini scores had greater BMI, more visceral fat, and lower handgrip strength.
- No-reflow phenomenon was significantly associated with lower handgrip strength and higher visceral fat.
- Multivariate analysis confirmed visceral fat and handgrip strength as predictors of no-reflow and high Gensini scores.
Conclusions:
- Increased visceral fat and decreased muscle strength are associated with a higher no-reflow rate and greater coronary plaque burden in STEMI.
- Visceral fat and muscle strength show potential as superior prognostic markers for coronary artery disease compared to traditional measures like BMI or total body weight.
Background:
The impact of fat distribution, muscle mass, and muscle strength on no-reflow and severity of coronary artery disease in patients with ST-segment elevation myocardial infarction (STEMI) remains unclear.
Objective:
To investigate association between muscle strength and fat and muscle mass and severity of coronary atherosclerosis.
Methods:
We included 218 patients with STEMI who had undergone primary percutaneous coronary intervention. We evaluated the no-reflow phenomenon in infarct-related artery and calculated Gensini scores from initial angiograms as indicative of coronary atherosclerosis severity. The patients were divided into 2 groups as patients with no-reflow and with thrombolysis in myocardial infarction grade 3 flow and patients with low (<55) Gensini and with high (≥55) Gensini. Patients' total fat, muscle mass, visceral fat mass, and muscle strength were measured via body composition analyzer and handgrip dynamometer.
Results:
High Gensini patients had a greater body mass index (BMI) and lower handgrip strength and more visceral fat ( P = .05, P = .017, and P < .001, respectively). The patients with no-reflow had significantly lower handgrip strength and more visceral fat (both, P < .001). In multivariate regression analysis, visceral fat and handgrip strength were associated with high no-reflow rate and high Gensini scores in patients with STEMI ( P = .001, P = .014, P = .022, and P = .010; respectively).
Conclusion:
Increased visceral fat and lower handgrip strength may be related to increased no-reflow rate and coronary plaque burden in STEMI. Visceral fat and muscle strength may be better prognostic markers than weight, BMI, total fat, and muscle mass in coronary artery disease.
