Reduced calf, mid-upper arm circumferences flag poor outcomes in CVD

In patients with cardiovascular disease (CVD), reductions in calf and mid-upper arm circumferences are predictive of poor outcomes, according to new research.

Researchers looked at 1,111 patients with CVD (median age 71 years, 62.5 percent male). Calf circumference and mid-upper arm circumference were measured at discharge and at the end of outpatient rehabilitation.

For the main analysis, the difference in anthropometric measures taken following outpatient rehabilitation was compared to those taken at the time of discharge. Patients with a negative difference were included in the decreased group, and those with zero or a positive difference were included in the no-decrease control group. The primary endpoint was a composite of all-cause death and all-cause rehospitalization.

For calf circumference, patients in the decreased group had a 42-percent greater risk of the composite events compared with those in the control group (hazard ratio [HR], 1.42, 95 percent confidence interval [CI], 1.06–1.92; p=0.021).

Results were similar for the mid-upper arm circumference. Relative to those in the control group, patients in the decreased group had a 61-percent higher risk of the composite events (HR, 1.61, 95 percent CI, 1.23–2.11; p<0.001).

These findings underscore the value of longitudinal calf circumference and mid-upper arm circumference when stratifying risk in CVD patients, the researchers said.