SARCOPENIA AS A PREDICTOR OF ADVERSE OUTCOMES IN PATIENTS WITH ACUTE CORONARY SYNDROME: A PROSPECTIVE COHORT STUDY

Sarcopenia has emerged as a systemic marker of biological vulnerability; however, its prognostic role in acute coronary syndrome (ACS) remains poorly explored, particularly in middle-income countries. This study investigated whether sarcopenia was associated with mortality and new coronary events during a 24-month follow-up period.

This prospective cohort study included 149 individuals aged ≥50 years admitted to a university hospital with a clinical diagnosis of ACS. Sarcopenia was defined according to the EWGSOP2 criteria, based on reduced handgrip strength and low muscle mass estimated by bioelectrical impedance analysis. Outcomes included all-cause mortality and new coronary events, obtained from medical records and 24-month follow-up. Survival analyses were estimated using the Kaplan-Meier method and compared using the log-rank test. The association between sarcopenia, mortality, and new coronary events was assessed using Cox proportional hazards regression models, with crude and adjusted hazard ratios (HRs).

Results: The prevalence of sarcopenia was 14.8%, while 51.7% of participants had excess weight. At 24 months, follow-up data were available for 113 participants (24.2% loss to follow-up), among these, 30.1% experienced new coronary events and 12.4% died. Patients with sarcopenia had lower overall survival and a higher cumulative incidence of new coronary events (log-rank p<0.05). In Cox regression models adjusted for age and sex, sarcopenia was associated with a higher risk of mortality (HR=7.2; 95%CI: 1.9-16.9) and new coronary events (HR=2.5; 95%CI: 1.1-6.0).

Sarcopenia was associated with a higher risk of mortality and new coronary events after adjustment for age and sex during the 24-month follow-up, supporting its potential relevance as a prognostic marker in patients with ACS. Sarcopenia screening may contribute to prognostic stratification and help identify patients who may benefit from further nutritional and functional assessment.