Heart failure & cardiomyopathies
Skeletal Muscle Mass and Mortality in Heart Failure: Mediation Role of Systemic Immune-Inflammatory Index
Authors' conclusion
Both low SMM and increased SII were significantly associated with unfavorable outcomes in HF. SII was partially mediated in the relationship between low SMM and cardiovascular death in HF.
Study context
- Population
- Inpatients from the RED-CARPET trial with a definitive diagnosis of heart failure (HF)patients with HF, 208 all-cause deaths and 106 cardiovascular deaths over a median follow-up of 4.9 years
- Participants
- 1,402 inpatients
- Exposure
- Each 1-SD decrement in skeletal muscle mass (SMM); higher SII
- Outcome
- All-cause death per 1-SD decrement in SMM
- Follow-up
- Median 4.9 years
Methodological detailsstratified by sex, mediation analysis
- Stratified by sex
- Mediation analysis
Main finding
As reported in the abstract
Hazard ratio (95% CI)P value
Each 1-SD decrement in SMM (males)males
2.17(1.20–3.91)
P = 0.01Each 1-SD decrement in SMM (females)females
2.90(1.27–6.67)
P = 0.012Each 1-SD decrement in SMM, as printed
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Cardiovascular death per 1-SD decrement in SMM · median follow-up 4.9 yearsEach 1-SD decrement in SMM (males) · males | 3.61 (1.56–8.40) | P = 0.003 | |
| Cardiovascular death per 1-SD decrement in SMM · median follow-up 4.9 yearsEach 1-SD decrement in SMM (females) · females | 6.67 ([2.33, 18.9]) | P < 0.001 | |
| 0.050.21520Hazard ratio (log scale) |
Adverse outcomes by SII
- Higher SII was associated with adverse outcomes
Mediation by SII of the relationship between SMM and cardiovascular death
- Proportion mediated, males
- 7.1% [proportion-mediated 95% CI: 0.5%-26%]; P = 0.036
- Proportion mediated, females
- 5.4% [proportion mediated 95% CI: 0%-18.8%]; P = 0.064
Original publication
Skeletal Muscle Mass and Mortality in Heart Failure: Mediation Role of Systemic Immune-Inflammatory Index. JACC Adv. Published 26 February 2025. doi:10.
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