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. 2025 Jan;29(1):100434.
doi: 10.1016/j.jnha.2024.100434. Epub 2024 Dec 5.

Prognostic implication of sarcopenia diagnosed by updated Asian Working Group for Sarcopenia criteria in older patients with heart failure: Utility and limitation

Satoshi Katano  1 , Kotaro Yamano  2 , Toshiyuki Yano  3 , Ryo Numazawa  4 , Ryohei Nagaoka  5 , Suguru Honma  6 , Yusuke Fujisawa  7 , Yasuhiro Miki  8 , Yuhei Takamura  9 , Hayato Kunihara  10 , Hiroya Fujisaki  10 , Hidemichi Kouzu  11 , Katsuhiko Ohori  12 , Masaki Katayose  2 , Akiyoshi Hashimoto  13 , Masato Furuhashi  11
Affiliations

Prognostic implication of sarcopenia diagnosed by updated Asian Working Group for Sarcopenia criteria in older patients with heart failure: Utility and limitation

Satoshi Katano et al. J Nutr Health Aging. 2025 Jan.

Abstract

Objectives: The utility of the updated Asian Working Group for Sarcopenia (AWGS) criteria in diagnosing sarcopenia in older patients with heart failure (HF) remains unclear.

Objective: To analyze the prevalence and prognostic impact of sarcopenia diagnosed by the updated AWGS criteria in older patients with HF.

Design: Ambispective cohort study.

Setting & subjects: 534 older patients with HF from a university hospital in Japan.

Measurements: Sarcopenia was assessed using different versions of the AWGS criteria: AWGS 2014, AWGS 2019H (muscle mass relative to height squared), and AWGS 2019B (muscle mass relative to BMI). The primary endpoint was all-cause mortality at three years post-discharge.

Results: Of 534 patients, 42%, 57%, and 44% were diagnosed with sarcopenia according to AWGS 2014, AWGS 2019H, AWGS 2019B, respectively. Among patients without AWGS 2014-defined sarcopenia, 23% were reclassified as having sarcopenia by AWGS 2019H criteria. Forty-four percent of sarcopenic patients diagnosed by AWGS 2019H were re-classified as non-sarcopenic by AWGS 2019B, with lower fat mass and poorer nutritional status. After the multivariate Cox proportional hazard analyses, an association between all-cause death and sarcopenia remained significant for AWGS 2014 (hazard ratio [HR], 1.55; 95% confidence interval [CI], 1.01-2.37) and AWGS 2019H (HR, 1.65; 95% CI, 1.05-2.59), but not for AWGS 2019B (HR, 0.99; 95% CI, 0.64-1.51).

Conclusion: The updated AWGS 2019H criteria detected more sarcopenic patients with HF while maintaining favorable predictive ability. The use of BMI-adjusted muscle mass reclassified underweight and malnourished patients as non-sarcopenic, limiting its impact on the mortality prediction in older patients with HF.

Keywords: AWGS; Heart failure; Mortality; Older; Prevalence; Sarcopenia.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

None
Graphical abstract
Fig. 1
Fig. 1
Kaplan-Meier survival curves showing the impact of sarcopenia based on different diagnostic criteria on all-cause mortality in older patients with HF. AWGS, Asian Working Group for Sarcopenia; HF, heart failure.
See this image and copyright information in PMC

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