Association Between Handgrip Strength and Mortality of Patients With Coronary Artery Disease: A Meta‐Analysis

Background Muscular strength has been linked to increased risk of cardiovascular disease in the community population. The aim of this systematic review and meta‐analysis is to evaluate the association between weak handgrip strength (HGS) and mortality risk in patients with coronary artery disease (CAD). Methods To carry out the meta‐analysis, an extensive search was conducted on databases such as PubMed, Embase, Web of Science, Cochrane Library, Wanfang, and CNKI to identify observational studies with longitudinal follow‐up. Random‐effects models were used to combine the findings, taking into account the potential influence of heterogeneity. Results Eight observational studies involving 10 543 patients with CAD were included. During a mean follow‐up duration of 20.4 months, 1327 (12.6%) patients died. Pooled results showed that weak HGS at baseline was associated with an increased risk of all‐cause mortality during follow‐up (risk ratio [RR]: 1.95, 95% confidence interval: 1.50 to 2.55, p < 0.001; I 2 = 62%). Subgroup analysis suggested a stronger association between weak HGS and increased mortality in older patients with CAD as compared to that of overall adult patients with CAD (RR: 3.01 vs. 1.60, p for subgroup difference = 0.004). Subgroup analyses according to study location, design, subtype of CAD, follow‐up duration, analytical model, and study quality scores showed similar results ( p for subgroup difference all > 0.05). Conclusions Weak HGS at baseline is associated with an increased risk of mortality in patients with CAD, particularly in older patients with CAD.