Probiotic supplementation did not improve muscle strength in the overall cohort of post-AMI patients undergoing revascularization, but in the exploratory subgroup of men aged ≥50 years with low baseline handgrip strength, it improved non-dominant handgrip strength by a mean difference of +4.6 kg/f compared to placebo (p=0.04) with baseline-adjusted ANCOVA showing interaction β=+0.33 (95% CI +0.02 to +0.62, p=0.038).
RCT (n=45)
triple-blind
block stratification method considering presence or absence of type 2 diabetes
No
Does probiotic supplementation improve handgrip strength in adults undergoing myocardial revascularization?
Routine probiotic supplementation does not improve overall muscle strength after myocardial revascularization, though exploratory data suggest a potential benefit in older men with low baseline strength.
Evidence suggests that gut dysbiosis may contribute to acute myocardial infarction (AMI) and its complications, including reduced physical performance and muscle weakness. We hypothesized that probiotic supplementation could improve muscle strength during post-AMI recovery. In a randomized, controlled, triple-blind clinical trial, adults and older adults undergoing myocardial revascularization received either a multistrain probiotic formulation (Lacticaseibacillus paracasei, Lacticaseibacillus rhamnosus, Lacticaseibacillus acidophilus, and Bifidobacterium lactis) or placebo for 90 days. The primary outcome was handgrip strength (HGS). Forty-five participants completed the study. No significant between-group differences were observed in the main analysis. However, in an exploratory subgroup of men aged 50 years and older with low baseline HGS (n = 30), probiotic supplementation led to a greater improvement in non-dominant HGS after 90 days compared with placebo (mean difference: +4.6 kg/f; p = 0.04). A baseline-adjusted ANCOVA confirmed a significant baseline-by-treatment interaction for the non-dominant hand (β = +0.33; 95% CI: +0.02 to +0.62; p = 0.038), indicating greater improvements among participants with lower initial strength. Although the primary analysis yielded null results, these exploratory findings indicate a potential benefit of probiotic supplementation in a clinically vulnerable subgroup of revascularized men with low baseline strength. Larger and prospectively powered trials are warranted to confirm these observations. Trial registration: RBR-6ztyb7.
Gimenes et al. (Wed,) conducted a rct in Adults and older adults (40-79 years) undergoing coronary artery bypass grafting due to ST-segment elevation myocardial infarction related to atherosclerotic coronary artery disease (n=45). Multistrain probiotic formulation containing Lacticaseibacillus paracasei CCT 7861, Lacticaseibacillus rhamnosus CCT 7863, Lacticaseibacillus acidophilus CCT 7947, and Bifidobacterium lactis CCT 7858 vs. Placebo with maltodextrin 1 g/day was evaluated on Handgrip strength (HGS) measured by hydraulic dynamometry in both dominant and non-dominant hands. Probiotic supplementation did not improve muscle strength in the overall cohort of post-AMI patients undergoing revascularization, but in the exploratory subgroup of men aged ≥50 years with low baseline handgrip strength, it improved non-dominant handgrip strength by a mean difference of +4.6 kg/f compared to placebo (p=0.04) with baseline-adjusted ANCOVA showing interaction β=+0.33 (95% CI +0.02 to +0.62, p=0.038).