Effect of muscle depletion on survival in peripheral arterial occlusive disease: Quality over quantity (2024)

Vedder, I. R., Levolger, S., Dierckx, R. A. J. O., Zeebregts, C. J., de Vries, J.-P. P. M., Viddeleer, A. R. (2020). Effect of muscle depletion on survival in peripheral arterial occlusive disease: Quality over quantity. Journal of Vascular Surgery, 72(6), 2006-2016.e1. https://doi.org/10.1016/j.jvs.2020.03.050

Vedder, Issi R ; Levolger, Stef ; Dierckx, Rudi A J O et al. / Effect of muscle depletion on survival in peripheral arterial occlusive disease : Quality over quantity. In: Journal of Vascular Surgery. 2020 ; Vol. 72, No. 6. pp. 2006-2016.e1.

@article{479f5c1d1ff64b45b2ed061f73e8c0e1,

title = "Effect of muscle depletion on survival in peripheral arterial occlusive disease: Quality over quantity",

abstract = "Objective: Patients with peripheral arterial occlusive disease (PAOD) have a poor prognosis and a high prevalence of comorbidity. This study investigated whether sarcopenia and/or myosteatosis negatively affect long-term survival in patients with PAOD.Methods: This was a single-center, retrospective cohort study of 686 consecutive patients diagnosed and treated for PAOD and who underwent computed tomography scanning. Cross-sectional muscle measurements were obtained at the level of the third lumbar vertebra. Optimal stratification was used to define sex-specific and body mass index-specific cutoff values for sarcopenia and myosteatosis, respectively. The Cox proportional hazards model was used to determine the effect of sarcopenia and myosteatosis on overall survival.Results: Sarcopenia was associated with age, body mass index, myosteatosis, malignancy, congestive heart failure, hemodialysis, and Fontaine 4 classification. Myosteatosis was associated with age, sarcopenia, type 2 diabetes mellitus, hypertension, chronic obstructive pulmonary disease, malignancy, congestive heart failure, ischemic stroke, and Fontaine 4 classification. Sarcopenia (hazard ratio [HP], 2.82; 95% confidence interval [CI], 2.05-3.86; P <.001) and myosteatosis (HR, 4.13; 95% CI, 3.03-5.63; P <.001) were both associated with reduced survival in univariable analysis. When adjusted for other prognostic markers, myosteatosis (HR, 2.09; 95% CI, 1.46-2.99; P <.001) was still associated with lower overall survival in the multivariable model, but sarcopenia (HR, 1.40; 95% CI, 0.97-2.01; P=.073) was not.Conclusions: Muscle depletion is independently associated with a poorer overall survival in patients with PAOD. Myosteatosis is a stronger predictor than sarcopenia, which indicates that quality is more important than quantity. Results should be interpreted with caution owing to missing data on medication usage.",

keywords = "PAOD, Sarcopenia, Myosteatosis, Intramuscular fat, Survival, Outcome, SKELETAL-MUSCLE, PROGNOSTIC-FACTOR, ELDERLY-MEN, SARCOPENIA, MASS, INFLAMMATION, ASSOCIATION, MANAGEMENT, MORTALITY, ADHERENCE",

author = "Vedder, {Issi R} and Stef Levolger and Dierckx, {Rudi A J O} and Zeebregts, {Clark J} and {de Vries}, {Jean-Paul P M} and Viddeleer, {Alain R} and Bokkers, {Reinoud P H}",

note = "Copyright {\textcopyright} 2020. Published by Elsevier Inc.",

year = "2020",

month = dec,

doi = "10.1016/j.jvs.2020.03.050",

language = "English",

volume = "72",

pages = "2006--2016.e1",

journal = "Journal of Vascular Surgery",

issn = "0741-5214",

publisher = "MOSBY-ELSEVIER",

number = "6",

}

Vedder, IR, Levolger, S, Dierckx, RAJO, Zeebregts, CJ, de Vries, J-PPM, Viddeleer, AR 2020, 'Effect of muscle depletion on survival in peripheral arterial occlusive disease: Quality over quantity', Journal of Vascular Surgery, vol. 72, no. 6, pp. 2006-2016.e1. https://doi.org/10.1016/j.jvs.2020.03.050

Effect of muscle depletion on survival in peripheral arterial occlusive disease: Quality over quantity. / Vedder, Issi R; Levolger, Stef; Dierckx, Rudi A J O et al.
In: Journal of Vascular Surgery, Vol. 72, No. 6, 12.2020, p. 2006-2016.e1.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Effect of muscle depletion on survival in peripheral arterial occlusive disease

T2 - Quality over quantity

AU - Vedder, Issi R

AU - Levolger, Stef

AU - Dierckx, Rudi A J O

AU - Zeebregts, Clark J

AU - de Vries, Jean-Paul P M

AU - Viddeleer, Alain R

AU - Bokkers, Reinoud P H

N1 - Copyright © 2020. Published by Elsevier Inc.

PY - 2020/12

Y1 - 2020/12

N2 - Objective: Patients with peripheral arterial occlusive disease (PAOD) have a poor prognosis and a high prevalence of comorbidity. This study investigated whether sarcopenia and/or myosteatosis negatively affect long-term survival in patients with PAOD.Methods: This was a single-center, retrospective cohort study of 686 consecutive patients diagnosed and treated for PAOD and who underwent computed tomography scanning. Cross-sectional muscle measurements were obtained at the level of the third lumbar vertebra. Optimal stratification was used to define sex-specific and body mass index-specific cutoff values for sarcopenia and myosteatosis, respectively. The Cox proportional hazards model was used to determine the effect of sarcopenia and myosteatosis on overall survival.Results: Sarcopenia was associated with age, body mass index, myosteatosis, malignancy, congestive heart failure, hemodialysis, and Fontaine 4 classification. Myosteatosis was associated with age, sarcopenia, type 2 diabetes mellitus, hypertension, chronic obstructive pulmonary disease, malignancy, congestive heart failure, ischemic stroke, and Fontaine 4 classification. Sarcopenia (hazard ratio [HP], 2.82; 95% confidence interval [CI], 2.05-3.86; P <.001) and myosteatosis (HR, 4.13; 95% CI, 3.03-5.63; P <.001) were both associated with reduced survival in univariable analysis. When adjusted for other prognostic markers, myosteatosis (HR, 2.09; 95% CI, 1.46-2.99; P <.001) was still associated with lower overall survival in the multivariable model, but sarcopenia (HR, 1.40; 95% CI, 0.97-2.01; P=.073) was not.Conclusions: Muscle depletion is independently associated with a poorer overall survival in patients with PAOD. Myosteatosis is a stronger predictor than sarcopenia, which indicates that quality is more important than quantity. Results should be interpreted with caution owing to missing data on medication usage.

AB - Objective: Patients with peripheral arterial occlusive disease (PAOD) have a poor prognosis and a high prevalence of comorbidity. This study investigated whether sarcopenia and/or myosteatosis negatively affect long-term survival in patients with PAOD.Methods: This was a single-center, retrospective cohort study of 686 consecutive patients diagnosed and treated for PAOD and who underwent computed tomography scanning. Cross-sectional muscle measurements were obtained at the level of the third lumbar vertebra. Optimal stratification was used to define sex-specific and body mass index-specific cutoff values for sarcopenia and myosteatosis, respectively. The Cox proportional hazards model was used to determine the effect of sarcopenia and myosteatosis on overall survival.Results: Sarcopenia was associated with age, body mass index, myosteatosis, malignancy, congestive heart failure, hemodialysis, and Fontaine 4 classification. Myosteatosis was associated with age, sarcopenia, type 2 diabetes mellitus, hypertension, chronic obstructive pulmonary disease, malignancy, congestive heart failure, ischemic stroke, and Fontaine 4 classification. Sarcopenia (hazard ratio [HP], 2.82; 95% confidence interval [CI], 2.05-3.86; P <.001) and myosteatosis (HR, 4.13; 95% CI, 3.03-5.63; P <.001) were both associated with reduced survival in univariable analysis. When adjusted for other prognostic markers, myosteatosis (HR, 2.09; 95% CI, 1.46-2.99; P <.001) was still associated with lower overall survival in the multivariable model, but sarcopenia (HR, 1.40; 95% CI, 0.97-2.01; P=.073) was not.Conclusions: Muscle depletion is independently associated with a poorer overall survival in patients with PAOD. Myosteatosis is a stronger predictor than sarcopenia, which indicates that quality is more important than quantity. Results should be interpreted with caution owing to missing data on medication usage.

KW - PAOD

KW - Sarcopenia

KW - Myosteatosis

KW - Intramuscular fat

KW - Survival

KW - Outcome

KW - SKELETAL-MUSCLE

KW - PROGNOSTIC-FACTOR

KW - ELDERLY-MEN

KW - SARCOPENIA

KW - MASS

KW - INFLAMMATION

KW - ASSOCIATION

KW - MANAGEMENT

KW - MORTALITY

KW - ADHERENCE

U2 - 10.1016/j.jvs.2020.03.050

DO - 10.1016/j.jvs.2020.03.050

M3 - Article

C2 - 32330596

SN - 0741-5214

VL - 72

SP - 2006-2016.e1

JO - Journal of Vascular Surgery

JF - Journal of Vascular Surgery

IS - 6

ER -

Vedder IR, Levolger S, Dierckx RAJO, Zeebregts CJ, de Vries JPPM, Viddeleer AR et al. Effect of muscle depletion on survival in peripheral arterial occlusive disease: Quality over quantity. Journal of Vascular Surgery. 2020 Dec;72(6):2006-2016.e1. Epub 2020 Apr 21. doi: 10.1016/j.jvs.2020.03.050