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Functional condition of skeletal muscles and prognosis aftermyocardial infarction in non-revascularized elderly patients

Authors: Bezdenezhnykh A.V., Sumin A.N.

Company: Research Institute for Complex Issues of Cardiovascular Diseases; Sosnovyy bul’var, 6, Kemerovo, 650002, Russian Federation

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DOI: https://doi.org/10.15275/kreatkard.2016.01.02

For citation: A.V. Bezdenezhnykh, A.N. Sumin; Functional condition of skeletal muscles and prognosis after myocardial infarction in non-revascularized elderly patients; Kreativnaya Kardiologiya. 2016; 10 (1): 13-24 (in Russian)

Keywords: myocardial infarction older age skeletal muscles prognosis

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Abstract

Objective. To investigate prognostic value of the functional status of skeletal muscles during five-years follow-up in elderly patients with myocardial infarction (MI). 

Material and methods. Ninety-four patients (49 males and 45 females, aged 61–85 years, median 72 years) with verified MI were passed through tests with physical exertion, echocardiography prior to discharge. Survived (n=61; 36 males, age median 71 years) and died (n=33; 13 males, age median 73 years) patients were compared on muscle performance and pre-discharge data. The influence of skeletal muscles condition on prognosis was studied using logistic regression analysis. The six minute walking test distance (6MWT), maximal load on cycle ergometry, knee flexors and extensors and respiratory muscles power (RMP) were included in analysis along with variables of proven predictive value (age, Killip class, left ventricle ejection fraction (LVEF)). 

Results. Handgrip strength was higher in survivals (right and left hand, p=0.044 и 0.029 respectively), weight pulled (p=0.039) and lifted from chest (p=0.008). Among died patients were lower RMP (p=0.038) and 6MWT (p=0.008). In univariate analysis the odds to die during five years after MI decreased with higher maximal load on cycle ergometry (p=0.011) and 6MWT distance (p=0.020). Higher values of strength of skeletal muscle were also associated with lower mortality at follow-up: for knee flexors (p=0.041) and extensors (p=0.038), and respiratory muscles (p=0.037). In multivariate analysis association retained for LVEF (p=0.009) and knee-extensors strength (p=0.049). 

Conclusion. The better condition of skeletal muscles has positive influence on prognosis in patients with MI over 60 years. The low LVEF value and low strength of knee extensors are associated with increased mortality during five-year follow up. Increase in 100 meters of 6MWT leads to twice reduction risk of death amongst older patients during five-year follow-up after MI.

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Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery


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