Handgrip strength and the prognosis of patients with heart failure: A meta‐analysis

Background Reduced muscular strength is common in patients with heart failure (HF). The aim of the systematic review and meta‐analysis was to evaluate the association between handgrip strength (HGS) and prognosis of patients with HF. Hypothesis Reduced HGS may be a risk factor of poor prognosis of patients with HF. Methods Relevant observational studies with longitudinal follow‐up were obtained by a comprehensive search of PubMed, Embase, Cochrane Library, and Web of Science databases. A random‐effects model was used to pool the results. Results Fifteen studies involving 7350 patients with HF were included in the meta‐analysis. Pooled results showed that HF patients with lower HGS were associated with a higher risk of mortality during follow‐up (risk ratio [RR]: 2.00, 95% confidence interval [CI]: 1.55–2.58, p < .001; I 2 = 0%). Subgroup analysis showed that the association was not significantly affected by characteristics such as study country, design, mean age of the patients, HF status (stable or advanced/acute), HF type (reduced or preserved ejection fraction), follow‐up duration, and quality score ( p for subgroup difference all > 0.05). Further analysis showed that per 1 kgf decrease of HGS was associated with an 8% increased risk of mortality during follow‐up (RR: 1.08, 95% CI: 1.05–1.11, p < .001; I 2 = 12%). Moreover, HF patients with lower HGS were also related to a higher risk of composite outcome of HF rehospitalization or mortality (RR: 1.67, 95% CI: 1.19–2.35, p = .003; I 2 = 53%). Conclusion A low HGS may be associated with poor clinical outcomes of patients with HF.