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Association between changes in calf and mid-upper arm circumference and prognosis in cardiovascular disease patients
Kaoru Sato1, Kentaro Kamiya2, Kensuke Ueno3
1Department of Rehabilitation Sciences, Graduate School of Medical Sciences, Kitasato University, Sagamihara, Kanagawa, Japan.
Insights
Decreased calf and mid-upper arm circumferences in cardiovascular disease (CVD) patients after rehabilitation indicate a poorer prognosis. Monitoring these anthropometric changes can help predict patient outcomes.
Area of Science:
- Cardiology
- Clinical Nutrition
- Public Health
Background:
- Calf circumference (CC) and mid-upper arm circumference (MUAC) are linked to cardiovascular disease (CVD) prognosis.
- The prognostic value of changes in CC and MUAC following treatment is not well understood.
Purpose of the Study:
- To investigate the relationship between changes in CC and MUAC and the prognosis for patients with CVD.
- To determine if a decrease in these anthropometric measures after rehabilitation predicts adverse events.
Main Methods:
- 1111 CVD patients had CC and MUAC measured at discharge and post-outpatient rehabilitation.
- Changes in CC and MUAC were calculated; patients were grouped into decreased vs. non-decreased.
- The primary endpoint was a composite of all-cause death and rehospitalization.
Main Results:
- A decrease in CC was associated with significantly higher composite event rates (HR 1.42, p=0.021).
- A decrease in MUAC also showed significantly higher composite event rates (HR 1.61, p<0.001).
Conclusions:
- Reductions in both CC and MUAC following rehabilitation are linked to poor prognosis in CVD patients.
- Regular monitoring of CC and MUAC may aid in predicting patient outcomes and guiding interventions.
Background And Aim:
Patients' calf and mid-upper arm circumferences have been associated with a prognosis of cardiovascular disease (CVD), but the relationship between a change in these measures and the prognosis is unclear. We aimed to investigate the relationship between changes in calf and mid-upper arm circumferences and the prognosis for patients with CVD.
Methods And Results:
We included 1111 patients with CVD (median age 71 years, 62.5% male) whose calf circumference (CC) and mid-upper arm circumference (MUAC) were assessed at discharge and at the end of outpatient rehabilitation. Changes were defined as a difference in anthropometric measures following outpatient rehabilitation compared to those taken at the time of discharge. Patients with a negative difference were included in the decreased group, and those with zero or a positive difference were included in the non-decreased group. The endpoint was composite events of all-cause death and all-cause rehospitalization. The decreased CC group had significantly higher composite event rates compared to the non-decreased group [hazard ratio (HR) 1.42; 95% confidence interval (CI) 1.06-1.92; p = 0.021], as did the decreased MUAC group [HR 1.61; 95% CI 1.23-2.11; p < 0.001].
Conclusion:
Decreases in CC and MUAC were associated with a poor prognosis in patients with CVD. Regular assessment of these measures may be valuable in predicting outcomes.
Registration Number:
KMEO B22-143.
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