Impact Of High Sarcopenic Risk In Patients Undergoing Inpatient Cardiac Rehabilitation After Cardiac Procedure

PURPOSE: This study aimed to screen iCR participants aged ≥75 for sarcopenia risk and quantify their functional capacity.

METHODS: A prospective, observational cohort study within the framework of the ongoing multicenter prehabilitation study "PRECOVERY". Patients undergoing iCR after a cardiac procedure were recruited from four German iCR facilities. At iCR (baseline), the Strength, Assistance with walking, Rise from a chair, Climb stairs and Falls (SARC-F) questionnaire identified patients with a high risk for sarcopenia. In addition, Katz-Index, Clinical Frailty Scale (CFS), handgrip strength (HGS), Short Physical Performance Battery (SPPB) and 6-minute walk distance (6MWD) measured functional capacity and frailty at baseline. Follow-up of SARC-F was performed three months later by telephone. Outcomes were the risk of sarcopenia, the correlation of a high sarcopenic risk to functional capacity at baseline, and the SARC-F score at follow-up. The Wilcoxon test and eta coefficient with one-way ANOVA were applied.

RESULTS: Data from 101 patients (79.9 ± 4.0 years; 63% male) were included in the analysis. At baseline, the mean SARC-F score was 2.7 ± 2.1, with 35% scoring ≥4, indicating a high likelihood of sarcopenia. Other baseline results were Katz-Index 5.7 ± 0.9, CFS 3.2 ± 1.4, HGS 24.9 ± 9.9 kg, SPPB score 7.5 ± 3.3 and 6MWD 288.8 ± 136.5 m. Compared to baseline, fewer patients had a risk of sarcopenia (23% compared to 35%) at follow-up. In the subgroup of patients with a high sarcopenic risk at baseline (n = 35), pre post comparison resulted in a significant SARC-F improvement (p = 0.017). A significant positive correlation was found between sarcopenic risk measured by SARC-F and poor results in functional capacity assessments (p < 0.001; r > 0.546).

CONCLUSIONS: Patients at iCR after cardiac procedure have a high probability of sarcopenia, which remains high during follow-up. Further studies are needed to quantify sarcopenia in iCR patients and to investigate the benefit of a multi-faceted prehabilitation program to improve sarcopenic status and functional outcomes.