Prognostic Impact and Prevalence of Cachexia in Patients With Heart Failure: A Systematic Review and Meta‐Analysis

ABSTRACT Background Cachexia, defined as the combination of weight loss, weakness, fatigue, anorexia and abnormal biochemical markers based on Evans' criteria, is known to exacerbate the prognosis of heart failure (HF) patients. This systematic review and meta‐analysis investigates the prognost...

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Main Authors: Konstantinos Prokopidis, Krzysztof Irlik, Mirela Hendel, Julia Piaśnik, Gregory Y. H. Lip, Katarzyna Nabrdalik
Format: Article
Language:English
Published: Wiley 2024-12-01
Series:Journal of Cachexia, Sarcopenia and Muscle
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Online Access:https://doi.org/10.1002/jcsm.13596
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author Konstantinos Prokopidis
Krzysztof Irlik
Mirela Hendel
Julia Piaśnik
Gregory Y. H. Lip
Katarzyna Nabrdalik
author_facet Konstantinos Prokopidis
Krzysztof Irlik
Mirela Hendel
Julia Piaśnik
Gregory Y. H. Lip
Katarzyna Nabrdalik
author_sort Konstantinos Prokopidis
collection DOAJ
description ABSTRACT Background Cachexia, defined as the combination of weight loss, weakness, fatigue, anorexia and abnormal biochemical markers based on Evans' criteria, is known to exacerbate the prognosis of heart failure (HF) patients. This systematic review and meta‐analysis investigates the prognostic impact and prevalence of cachexia, as defined by Evans' criteria, in patients with HF. Methods PubMed, Cochrane Library, Scopus and Web of Science were searched from inception until December 2023, including HF patients for whom the Evans' criteria were applied to explore the prevalence and prognostic impact of cachexia. This study employed a meta‐analyses using the random‐effects model and inverse‐variance method that was adhered to the revised 2020 PRISMA guidelines for systematic reviews and meta‐analyses (CRD42023446443). Results Six prospective or retrospective studies of 2252 patients with HF were included, whereby all‐cause mortality was significantly greater in patients with cachexia with low heterogeneity among studies (HR: 1.60, 95% CI 1.31–1.95, p < 0.001; I2 = 0%). For the studies that used full, uniformly defined Evans' criteria, among 1844 patients, mortality remained greater in patients with cachexia (HR: 1.58, 95% CI 1.27–1.97, p < 0.001; I2 = 0%). In a subgroup analysis among 1714 of HF with reduced ejection fraction, the results were consistent (HR: 1.57, 95% CI 1.28–1.92, p < 0.001; I2 = 0%). Additionally, 10 studies comprising 2862 patients indicated a 31% risk of cachexia in HF (95% CI 21–43%, I2 = 94%). Conclusions Cachexia is an independent predictor for increased all‐cause mortality among patients with HF with a notable prevalence of 31%. Interventions aiding in improving fatigue, anorexia and exercise capacity could help improve the quality of life of this clinical population.
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spelling doaj-art-5898eae07e1d46a8bdf24f8da694c8492024-12-12T02:31:37ZengWileyJournal of Cachexia, Sarcopenia and Muscle2190-59912190-60092024-12-011562536254310.1002/jcsm.13596Prognostic Impact and Prevalence of Cachexia in Patients With Heart Failure: A Systematic Review and Meta‐AnalysisKonstantinos Prokopidis0Krzysztof Irlik1Mirela Hendel2Julia Piaśnik3Gregory Y. H. Lip4Katarzyna Nabrdalik5Department of Musculoskeletal Ageing and Science, Institute of Life Course and Medical Sciences University of Liverpool Liverpool UKLiverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart & Chest Hospital Liverpool UKStudents' Scientific Association by the Department of Internal Medicine, Diabetology and Nephrology in Zabrze, Faculty of Medical Sciences in Zabrze Medical University of Silesia Katowice PolandStudents' Scientific Association by the Department of Internal Medicine, Diabetology and Nephrology in Zabrze, Faculty of Medical Sciences in Zabrze Medical University of Silesia Katowice PolandLiverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart & Chest Hospital Liverpool UKLiverpool Centre for Cardiovascular Science at University of Liverpool Liverpool John Moores University and Liverpool Heart & Chest Hospital Liverpool UKABSTRACT Background Cachexia, defined as the combination of weight loss, weakness, fatigue, anorexia and abnormal biochemical markers based on Evans' criteria, is known to exacerbate the prognosis of heart failure (HF) patients. This systematic review and meta‐analysis investigates the prognostic impact and prevalence of cachexia, as defined by Evans' criteria, in patients with HF. Methods PubMed, Cochrane Library, Scopus and Web of Science were searched from inception until December 2023, including HF patients for whom the Evans' criteria were applied to explore the prevalence and prognostic impact of cachexia. This study employed a meta‐analyses using the random‐effects model and inverse‐variance method that was adhered to the revised 2020 PRISMA guidelines for systematic reviews and meta‐analyses (CRD42023446443). Results Six prospective or retrospective studies of 2252 patients with HF were included, whereby all‐cause mortality was significantly greater in patients with cachexia with low heterogeneity among studies (HR: 1.60, 95% CI 1.31–1.95, p < 0.001; I2 = 0%). For the studies that used full, uniformly defined Evans' criteria, among 1844 patients, mortality remained greater in patients with cachexia (HR: 1.58, 95% CI 1.27–1.97, p < 0.001; I2 = 0%). In a subgroup analysis among 1714 of HF with reduced ejection fraction, the results were consistent (HR: 1.57, 95% CI 1.28–1.92, p < 0.001; I2 = 0%). Additionally, 10 studies comprising 2862 patients indicated a 31% risk of cachexia in HF (95% CI 21–43%, I2 = 94%). Conclusions Cachexia is an independent predictor for increased all‐cause mortality among patients with HF with a notable prevalence of 31%. Interventions aiding in improving fatigue, anorexia and exercise capacity could help improve the quality of life of this clinical population.https://doi.org/10.1002/jcsm.13596cachexiaheart failuremortalitymuscle wastingweight loss
spellingShingle Konstantinos Prokopidis
Krzysztof Irlik
Mirela Hendel
Julia Piaśnik
Gregory Y. H. Lip
Katarzyna Nabrdalik
Prognostic Impact and Prevalence of Cachexia in Patients With Heart Failure: A Systematic Review and Meta‐Analysis
Journal of Cachexia, Sarcopenia and Muscle
cachexia
heart failure
mortality
muscle wasting
weight loss
title Prognostic Impact and Prevalence of Cachexia in Patients With Heart Failure: A Systematic Review and Meta‐Analysis
title_full Prognostic Impact and Prevalence of Cachexia in Patients With Heart Failure: A Systematic Review and Meta‐Analysis
title_fullStr Prognostic Impact and Prevalence of Cachexia in Patients With Heart Failure: A Systematic Review and Meta‐Analysis
title_full_unstemmed Prognostic Impact and Prevalence of Cachexia in Patients With Heart Failure: A Systematic Review and Meta‐Analysis
title_short Prognostic Impact and Prevalence of Cachexia in Patients With Heart Failure: A Systematic Review and Meta‐Analysis
title_sort prognostic impact and prevalence of cachexia in patients with heart failure a systematic review and meta analysis
topic cachexia
heart failure
mortality
muscle wasting
weight loss
url https://doi.org/10.1002/jcsm.13596
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AT mirelahendel prognosticimpactandprevalenceofcachexiainpatientswithheartfailureasystematicreviewandmetaanalysis
AT juliapiasnik prognosticimpactandprevalenceofcachexiainpatientswithheartfailureasystematicreviewandmetaanalysis
AT gregoryyhlip prognosticimpactandprevalenceofcachexiainpatientswithheartfailureasystematicreviewandmetaanalysis
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