Samenvatting

Patients who had an ischemic stroke have a poor life expectancy. To improve prognosis in ischemic stroke it is needed to discover additional prognostic biomarkers. This study investigated whether sarcopenia or myosteatosis affected long-term survival in ischemic stroke patients. The secondary aim was to investigate the neurological outcome of patients with and without myosteatosis.

This was a single-centre retrospective cohort study of 193 patients with a confirmed large vessel occlusion who had a computed-tomography scan. Skeletal muscle measurements were done at the third cervical vertebra. Optimal stratification was used to determine gender-specific cut-off points for sarcopenia and myosteatosis. Cox proportional hazards model was used to determine the effect of sarcopenia and myosteatosis on survival. Ordinal regression was used to determine neurological outcome using the modified Rankin Scale.

Myosteatosis was associated with age, INR level, thrombocyte count, creatinine level, CRP level, glucose level, myocardial infarction, peripheral artery disease, diabetes, hypertension, atrial fibrillation, hypercholesterolemia, and sarcopenia. Sarcopenia (HR 0.796, CI 0.455-1.393; p=0.424) did not display an effect on survival in the univariable analysis. Myosteatosis (HR 0.554, CI 0.335-0.916; p=0.021) had a significant influence on survival in the univariable analysis. When adjusted for other prognostic markers, myosteatosis (HR 0,598, CI 0.495-1.499; p=0.598) did not show effect on survival. No difference in neurological outcome was seen between having myosteatosis and not having myosteatosis in the ordinal regression.

Sarcopenia and myosteatosis are not associated with overall survival and neurological outcome in ischemic stroke patients.