ASSOCIATION BETWEEN STANDARDIZED PHASE ANGLE AND MAJOR ADVERSE EVENTS IN 12 MONTHS OF PATIENTS AFFECTED BY ACUTE MYOCARDIAL INFARCTION: A COHORT STUDY
Coronary Arterial Disease. Bioelectrical impedance. Adverse Events. Hospital Readmission. Hospitalization.
Cardiovascular diseases (CVDs) underscore themselves as the main cause of death in the world, and this includes coronary diseases. Amongst coronary diseases, the acute myocardial infarction (AMI) is defined as myocardial necrosis in a consistent clinical condition with myocardial ischemia. It is an acute cardiac event with an impact on the health condition, and its risk factors are usually a combination of the use of tobacco, inadequate diet, obesity, and sedentary lifestyle, besides to pre-existing comorbidities. These risk factors can compromise the cellular integrity impacting on physiological and nutritional components. In this approach, the phase angle (PA) has measured by bioelectrical impedance (BIA) and identifies the quality of the cell membrane and the distribution of body fluids. There are previous evidences that, this biomarker has a high negative predictive power of clinical outcomes, such as mortality and hospital readmission in several clinical situations. However, it has not been evaluated yet the association of PA with adverse events in patients who were recently affected by AMI. Therefore, our work aims to check if the PA is predictor of mortality and adverse clinical events in 12 months of patients who were recently affected by AMI. It was done a 12-month prospective cohort study. Furthermore, it was included adults and elderly patients with both sexes who were admitted to the University Hospital Onofre Lopes (UHOL/FURN) with a diagnosis of AMI. The patients were evaluated during hospitalization, and it was collected demographic, clinical, and nutritional data. Body weight, height, and calf circumference was measured using the anthropometric technique. Handgrip strength was measured with a manual dynamometer. The PA was calculated through the measuring of the resistance (R) and reactance (Xc) of the BIA, and it was adjusted based on sex and age, presenting, therefore, the standardized PA (SPA). Major adverse cardiac events (MACE) were observed during follow-up and among them, new hospital admission for unstable angina, new myocardial infarction and cardiovascular mortality were included in the analyses. All patients were followed for 12 months. The sample consisted of 153 patients, with a mean age of 61.2 ± 12.6 years, being 57.5% elderly. Patients who presented the standardized phase angle below the 10th percentile had a shorter time for the occurrence of death (p=0.024). In the univariate analysis, mortality was shown as a significant outcome (p= 0.036), but the other outcomes did not show an association in the Cox regression when adjusted for the confounding factor. In conclusion, patients recently affected by AMI and who had low AFP had a higher incidence of mortality at 12 months. However, when adjusted for cardiovascular risk factors, we found no association between AFP and ECAM and mortality.