Psoas muscle index as a predictor of mortality following per-cutaneous coronary intervention

Steven Hopkins; Siya Bhagat; Jonathan Zawadzki; Ian Pollack; Jeffrey Fowler; Catalin Toma; Joseph Ibrahim; Jonathan D.Wolfe; Gavin W.Hickey

doi:10.26599/1671-5411.2025.11.005

摘要：Background Percutaneous coronary intervention(PCI)is a widely utilized revascularization technique for coronary artery dis-ease(CAD).While clinical and biomarker-based prognostic tools are standard for predicting outcomes,there is growing interest in sarcopenia as a marker of frailty and its potential role in long-term prognosis.The prognostic value of the psoas muscle index(PMI),a sarcopenia metric,remains underexplored in PCI populations regarding long term survival. Methods This single-center retrospective cohort study evaluated 177 patients undergoing PCI from 2015 to 2019.PMI was cal-culated from computed tomography(CT)imaging at the L3 vertebral level using the formula:(left psoas area+right psoas area)/height2 and expressed in cm2/m2.Sarcopenia was defined as the lowest sex-specific PMI quartile.Primary outcomes in-cluded 5-year all-cause mortality and 3-point major adverse cardiovascular events(MACE:non-fatal myocardial infarction,ischemic stroke,and cardiac death).Binary linear regression and Cox proportional hazards models were utilized to determine as-sociations between PMI and outcomes Results Sarcopenic patients exhibited significantly higher 5-year all-cause mortality compared to non-sarcopenic counterparts(64.4%vs.35.6%,P<0.001),while no significant difference was observed in 3-point MACE incidence(55.6%vs.51.4%,P=0.520).Sarcopenia was independently associated with all-cause mortality on binary logistic regression(OR = 3.49;95%CI:1.69-7.19;P = 0.0007),but not MACE(OR = 1.00;95%CI:0.50-1.98;P = 0.99).In a multivariable Cox regression model,sarcopenia was asso-ciated with increased hazard of mortality(HR = 1.60;95%CI:0.96-2.66;P = 0.071),though this did not reach statistical signific-ance.Kaplan-Meier analysis demonstrated significantly reduced survival among sarcopenic patients(χ2=6.13,P=0.0133). Conclusions PMI is a significant independent predictor of 5-year all-cause mortality in PCI patients,underscoring the pro-gnostic importance of assessing skeletal muscle mass in this population.