Given the established background of sarcopenia in elderly populations, our study’s findings offer novel insights into its specific associations with short-term outcomes in patients with CHD. The observed associations underscore the imperative for early identification and intervention strategies aimed at mitigating sarcopenia’s adverse effects.

Sarcopenia is a common occurrence in elderly people but may also affect other age groups, which is reflected by the occurrence of sarcopenia within our specific study sample rather than a generalisable prevalence rate. The condition is often associated with age-related muscle loss, lack of physical activity, chronic diseases, poor nutrition and other factors. Its main feature is a systemic reduction in skeletal muscle mass, leading to an overall decline in the patient’s muscle mass and function [7, 8]. This may result in reduced mobility, increased fatigue, decreased physical strength and a decrease in quality of life. Sarcopenia was associated with an increased risk of all-cause mortality, several chronic diseases, and functional dependence [9]. Sarcopenia is also associated with other health issues, such as an increased risk of fractures and weakened immune system function, making it a widespread concern among elderly people. In elderly patients with CHD, the occurrence of sarcopenia becomes more prevalent due to the long-term impact of cardiovascular diseases [10,11,12].

This study aims to explore sarcopenia in elderly patients with CHD in depth, seeking to understand its occurrence and potential associations with short-term prognosis. Sarcopenia diagnosis was initially performed using indicators such as walking speed and grip strength, with patients divided into a sarcopenia group and a non-sarcopenia group. The study found that sarcopenia is relatively common in elderly patients with CHD. Previous research has indicated that as age increases, the muscle mass and function of older individuals gradually decline, closely related to the occurrence of sarcopenia. Patients with CHD often experience a decrease in physical activity due to the impact of cardiovascular diseases, which accelerates muscle loss. Additionally, long-term cardiovascular diseases may induce inflammation reactions in the body, exacerbating the decrease in muscle mass [13,14,15]. Therefore, the high incidence of sarcopenia in elderly patients with CHD needs sufficient attention, consistent with the results of this study.

Subsequently, measurements of cardiac parameters, including cardiac output, LVEF, LVEDD, LVESD, IVST and lLVPWT, were taken to gain a more comprehensive understanding of the cardiovascular conditions of patients with sarcopenia. The increased IVST observed in patients with sarcopenia may be influenced by various factors, including age-related structural changes or a higher prevalence of comorbidities, such as hypertension, which can lead to cardiac remodelling. Additionally, sarcopenia itself is often associated with systemic inflammation and altered haemodynamics, which may contribute to structural changes in the heart. Studies have shown that there is also a bidirectional relationship between sarcopenia and chronic heart failure (HF), Chronic HF can contribute to the development of sarcopenia through various pathophysiological mechanisms, while sarcopenia, in turn, may promote the onset of HF through distinct pathways, further exacerbating the already poor prognosis of chronic HF [16]. The intertwining and mutually reinforcing relationship between cardiac dysfunction and sarcopenia was highlighted. Other studies have found that sarcopenia also interacts with a variety of diseases, such as idiopathic pulmonary fibrosis, cancer, and Alzheimer’s disease [17,18,19]. Sarcopenia is a significant complication of cardiac dysfunction, and its occurrence can also be accelerated by cardiac dysfunction. The coexistence of cardiovascular pathology and sarcopenia not only significantly increases the readmission and mortality rates but also severely affects the prognosis and quality of life of patients. In the results of this study, cardiac output and LVEF levels were significantly lower in patients with sarcopenia than in those without sarcopenia, while LVEDD, LVESD, IVST and LVPWT measurements were significantly higher in patients with sarcopenia than in those without. This indicates that sarcopenia may result from a decrease in muscle strength, leading to impaired motor function and symptoms, such as difficulty breathing, decreased cardiac function or even weakness [20, 21]. This supports the hypothesis that sarcopenia accelerates cardiovascular decline by limiting oxygen delivery to peripheral tissues and reducing physical reserve, while cardiac dysfunction reciprocally exacerbates sarcopenia by impairing nutrient and oxygen delivery to muscles [22]. This finding emphasises the close association between cardiac function and sarcopenia, suggesting that both should be comprehensively considered in treatment and intervention efforts.

Subsequently, a one-year follow-up assessment was conducted, revealing a significant association of sarcopenia with the short-term prognosis of elderly patients with CHD. The results indicated that elderly patients with both CHD and sarcopenia had a higher probability of unconventional medical visits after discharge. Therefore, comprehensive health education should be provided to patients and their families upon discharge, enhancing their awareness of health management. Furthermore, considering the widespread presence of sarcopenia in elderly patients with CHD, multiple studies have identified sarcopenia as an independent prognostic factor for CHD. A meta-analysis of 3,707 patients showed that patients with sarcopenia had a higher incidence of MACE compared with patients without sarcopenia, with a relative risk (HR) of 2.27. Another study demonstrated a significant correlation between sarcopenia and MACE, with an HR of 2.86. Additionally, the combination of sarcopenia and high Cardiometabolic Index (CMI) is associated with an increased risk of developing cardiometabolic multimorbidity (CMM) [23]. These research findings underscore the importance of sarcopenia as a factor that cannot be overlooked in elderly patients with CHD, serving as not only an independent risk factor for poor prognosis but also being associated with the occurrence of CHD and adverse outcomes following percutaneous coronary intervention (PCI) treatment [24]. Therefore, considering the results of this study, special attention should be given to the presence of sarcopenia in elderly patients with CHD, whether or not they have suffered from acute myocardial infarction or are undergoing PCI treatment. This is crucial. Some scholars have proposed that sarcopenia not only affects patients’ quality of life but may also exacerbate the progression of cardiovascular diseases. The reduction in muscle mass may lead to decreased physical activity in patients, increasing the burden on the heart and aggravating the condition of CHD [25, 26]. Additionally, sarcopenia may affect patients’ nutritional status, making them more susceptible to complications such as weight loss and anaemia, further impacting short-term prognosis [27, 28]. However, this was not reflected in this study and requires continuous research in subsequent studies. Furthermore, we analysed different causes of death, including cardiovascular diseases, severe pneumonia, malignant tumours, diabetic ketoacidosis and unknown causes. This helps to understand the overall mortality rate and distribution of causes of death in sarcopenic patients comprehensively. To improve the occurrence and prognosis of sarcopenia in elderly patients with CHD, it is necessary to implement comprehensive intervention measures. First, regular exercise and rehabilitation training can enhance patients’ muscle mass and function, slowing down the development of sarcopenia. Second, reasonable dietary adjustments and nutritional support are also crucial for improving the muscle condition of elderly patients with CHD. In addition, treatment for cardiovascular diseases should receive sufficient attention to alleviate the burden on the heart and reduce the risk of cardiovascular events [29, 30].

Despite the robust findings of our study, several limitations must be acknowledged. First, the relatively small sample size and single-centre design limit the generalisability of our results. Second, while our study focused on short-term outcomes, the long-term associations of sarcopenia with clinical prognosis remain to be elucidated in future studies with extended follow-up periods. Third, we acknowledge that, as a retrospective study, our findings reflect the occurrence of sarcopenia within the specific cohort studied and do not provide a generalizable prevalence of sarcopenia in all patients with coronary artery disease (CAD). This limitation stems from the study design and the specific inclusion criteria used, which may not capture the broader population of CAD patients. Fourth, the diagnostic criteria for sarcopenia, although standardized, may not fully capture inter-individual variations in muscle function and mass across diverse populations. This measurement bias may lead to an underestimation or overestimation of sarcopenia prevalence and its relationship with cardiac outcomes. Selection bias may have resulted in an overrepresentation of certain patient characteristics, while information bias from incomplete records could underestimate the true associations. Finally, the cross-sectional nature of our data collection precludes any causal inferences regarding the relationship between sarcopenia and cardiac outcomes. Addressing these limitations in future multicentre, prospective studies with larger sample sizes and extended follow-up will enhance the generalisability of findings and provide more robust evidence for the interplay between sarcopenia and cardiovascular outcomes.

This study, through multidimensional observation and analysis, delves into the occurrence of sarcopenia in elderly patients with CHD and its associations with short-term prognosis. By providing a deep and comprehensive understanding of the occurrence of sarcopenia and its effects on short-term prognosis, the study offers a scientific basis for formulating more effective intervention measures and providing comprehensive support for the health management of elderly patients with CHD.