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

ABSTRACT Background 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. Methods 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. Results 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). Conclusions Sarcopenia was associated with a worse long‐term prognosis in older patients with stage B HF, highlighting the importance of early diagnosis of sarcopenia.