Prevalence, characteristics, and prognostic associations of sarcopenia in older adults with heart failure

To examine the clinical characteristics of Japanese older sarcopenic patients with heart failure (HF) diagnosed by the Asian Working Group for Sarcopenia 2025 (AWGS 2025) criteria.

The participants were patients with HF aged ≥ 65 years who required hospitalization. At discharge, when their condition was stable, the diagnosis of sarcopenia, laboratory measurements, and echocardiography were conducted, and the occurrence of all-cause and cardiovascular mortality and hospitalization after discharge was investigated. We investigated the association between sarcopenia diagnosed by AWGS 2025 and mortality risk.

We recruited 253 patients (mean age, 82.2 years; male, 51.0%; BNP, 182.8 pg/dL). The prevalence of sarcopenia among all participants was 59.3% after adjusting for skeletal muscle mass using either method (53.8% after adjusting for height and 47.4% after adjusting for BMI). For BMI < 22 or ≥ 25 kg/m², the prevalence of sarcopenia differed depending on the skeletal muscle adjustment method. The log-rank tests showed that the AWGS 2025 criteria were significantly associated with all-cause and cardiovascular mortality. In the Cox proportional hazards analysis, after adjusting for age, sex, HF stage and prognostic factors for heart failure, the AWGS 2025 criteria were also associated with all-cause and cardiovascular mortality in patients with HF, irrespective of the adjustment methods.

Older patients with HF have a high rate of sarcopenia, and sarcopenia, as defined by the AWGS 2025 criteria, is associated with an increased mortality risk.