People with heart failure, sarcopenia and chagas disease: A systematic review and meta-analysis

Background: This systematic review aims to estimate the prevalence of sarcopenia in people with heart failure (HF) and assess whether there is a difference in sarcopenia prevalence based on the underlying cause of HF, specifically comparing HF due to Chagas (HF-C) disease with HF from other causes (HF-NC). Methods: A systematic review of randomized controlled trials, cohort studies, cross-sectional studies, and case-control studies was carried out. Individuals with HF over 18 years who had their frequency of sarcopenia evaluated were included. Results: Overall, 3347 studies were found, of which 199 had their full texts evaluated. A total of 25 records were identified. The prevalence of sarcopenia, as defined by EWGSOP2 criteria, was 23.27% (95%CI 15.4, 33.6). Further, there were differences in sarcopenia prevalence according to the definition used in the studies (p-value = 0.0002). The odds ratio of sarcopenia in people with HF was 2.3 (95%CI 1.1, 4.8). Two studies specifically evaluated sarcopenia in HF-C, reporting a prevalence of 24.2% (95%CI 12.6, 41.5). The odds ratio for sarcopenia in HF-C was 1.93 (95% CI 0.40, 9.30) compared to HF-NC. Conclusions: Patients with HF have an increased risk of developing sarcopenia. However, the prevalence of sarcopenia varies according to the definition used. Furthermore, our findings highlight the hypothesis that the risk of sarcopenia in HF-C might be higher than HF-NC. Author summary: A systematic review of randomized controlled trials, cohort studies, cross-sectional studies, and case-control studies was carried out to estimate the prevalence of sarcopenia in people with heart failure (HF) and assess whether there is a difference in sarcopenia prevalence based on the underlying cause of HF, specifically comparing HF due to Chagas (HF-C) disease with HF from other causes (HF-NC). Overall, 3347 studies were found, of which 199 had their full texts evaluated. A total of 25 records were identified. There were differences in sarcopenia prevalence according to the definition used in the studies (p-value = 0.0002). The odds ratio of sarcopenia in people with HF was 2.3 (95%CI 1.1, 4.8). Two studies specifically evaluated sarcopenia in HF-C, reporting a prevalence of 24.2% (95%CI 12.6, 41.5). The odds ratio for sarcopenia in HF-C was 1.93 (95% CI 0.40, 9.30) compared to HF-NC. Our findings suggest the hypothesis that the risk of sarcopenia in HF-C might be higher than HF-NC.