Prevalence and Prognostic Implication of Sarcopenia Among Patients With Stage B Heart Failure: The PAPRIKA‐HF Cohort Study

The long-term prognosis of patients with heart failure (HF) remains poor. Most patients with HF are older, and multiple factors involved in geriatric syndromes are associated with worse long-term prognosis. Sarcopenia is a major component of geriatric syndrome. Early diagnosis and therapeutic intervention for sarcopenia are clinically important in patients with HF; however, the prevalence and long-term prognostic impact of sarcopenia in patients with stage B HF remain unclear. This study aimed to determine the prevalence of sarcopenia in older patients with stage B HF and its impact on the long-term prognosis. The PAPRIKA-HF study was a multicenter, prospective study that enrolled outpatients ≥ 65 years who were diagnosed with stage B HF. Sarcopenia was assessed based on the Asian Working Group for Sarcopenia 2019 diagnostic criteria. The primary endpoint was a composite endpoint (all-cause mortality, incident myocardial infarction, or hospitalization for heart failure) of > 2 years. Among 312 patients (mean age: 78.2 ± 6.5 years, 45% female), 17.7% (56 of 312 patients) had sarcopenia. The rate of the composite endpoint over 2 years was significantly higher in patients with sarcopenia than in those without (25.0% vs. 2.7%, log-rank test, p < 0.0001). Multivariate analysis using the Cox proportional hazards model showed that sarcopenia was an independent predictor of long-term prognosis (hazard ratio: 5.78, 95% confidence interval: 2.16-15.43, p < 0.001). Sarcopenia was associated with a worse long-term prognosis in older patients with stage B HF, highlighting the importance of early diagnosis of sarcopenia.