Grip strength predicts cardiac adverse events in patients with cardiac disorders: An individual patient pooled meta-analysis

Rita Pavasini, Matteo Serenelli, Carlos A. Celis-Morales, Stuart R. Gray, Kazuhiro P. Izawa, Satoshi Watanabe, Eloisa Colin-Ramirez, Lilia Castillo-Martínez, Yasuhiro Izumiya, Shinsuke Hanatani, Yoshiro Onoue, Kenichi Tsujita, Peter S. Macdonald, Sunita R. Jha, Véronique L. Roger, Sheila M. Manemann, Juan Sanchis, Vicente Ruiz, Giulia Bugani, Elisabetta TonetRoberto Ferrari, Stefano Volpato, Gianluca Campo

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

Objective Grip strength is a well-characterised measure of weakness and of poor muscle performance, but there is a lack of consensus on its prognostic implications in terms of cardiac adverse events in patients with cardiac disorders. Methods Articles were searched in PubMed, Cochrane Library, BioMed Central and EMBASE. The main inclusion criteria were patients with cardiac disorders (ischaemic heart disease, heart failure (HF), cardiomyopathies, valvulopathies, arrhythmias); evaluation of grip strength by handheld dynamometer; and relation between grip strength and outcomes. The endpoints of the study were cardiac death, all-cause mortality, hospital admission for HF, cerebrovascular accident (CVA) and myocardial infarction (MI). Data of interest were retrieved from the articles and after contact with authors, and then pooled in an individual patient meta-analysis. Univariate and multivariate logistic regression was performed to define predictors of outcomes. Results Overall, 23 480 patients were included from 7 studies. The mean age was 62.3±6.9 years and 70% were male. The mean follow-up was 2.82±1.7 years. After multivariate analysis grip strength (difference of 5 kg, 5× kg) emerged as an independent predictor of cardiac death (OR 0.84, 95% CI 0.79 to 0.89, p<0.0001), all-cause death (OR 0.87, 95% CI 0.85 to 0.89, p<0.0001) and hospital admission for HF (OR 0.88, 95% CI 0.84 to 0.92, p<0.0001). On the contrary, we did not find any relationship between grip strength and occurrence of MI or CVA. Conclusion In patients with cardiac disorders, grip strength predicted cardiac death, all-cause death and hospital admission for HF. Trial registration number CRD42015025280.

Original languageEnglish (US)
Pages (from-to)834-841
Number of pages8
JournalHeart
Volume105
Issue number11
DOIs
StatePublished - Jun 1 2019

Keywords

  • heart disease
  • heart failure
  • meta-analysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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