Analysis of body composition characteristics and prognostic risk factors in patients with non-ST segment elevated acute coronary syndrome

Abstract:

Objective：To investigate the characteristics of body components and prognostic factors in patients with non ST segment elevation acute coronary syndrome（NSTEACS）. Methods：This study included 466 NSTEACS patients meeting the conditions between January 2013 and October 2019 General clinical data were collected. Participants’ body composition characteristics were judged by fat and muscle measured by abdominal CT，and they were divided into control group，obesity group，sarcopenia group and sarcopenic obesity group. Prospective follow-up was performed in all patients. The endpoint event was major adverse cardiac event（MACE）. The Kaplan-Meier method was used to estimate the survival rate. Multivariate Cox proportional hazards regression was used to analyze the relationship between body composition and MACE. Results：There were 106 cases（22.7%） in the control group，172 cases（36.9%） in the obese group，79 cases（17.0%） in the sarcopenia group，and 109 cases（23.4%） in the sarcopenic obesity group. There were significant differences in survival curves between the 4 groups（ χ2=30.674，P=0.000）. Survival curves between control group and obe－sity group（χ2=6.099，P=0.014），control group and sarcopenia group（ χ2=9.332，P=0.002），obesity group and sarcopenia group（ χ2=27.775，P=0.000），obesity group and sarcopenic obesity group（ χ2=12.642，P=0.000），sarcopenia group and sarcopenic obesity group（ χ2=3.972，P=0.046） were significant different. There was no significant difference between the obesity group and the sarcopenia group（ χ2=0.948，P=0.330）. Multivariate Cox regression showed that diabetes，high GRACE score，obesity，sarcopenia，and sarcopenic obesity were independent risk factors for MACE，while percutaneous coronary intervention（PCI） was a protective factor for reducing MACE. Conclusion：There is no obesity paradox in patients with NSTEACS. Sarcopenic obesity，sarcopenia and obesity are risk factors for cardiovascular events in NSTEACS patients. The results help to further perform risk stratification for NSTEACS patients.