Abstract 14063: Hand Grip Strength Significantly Predicts Cardiovascular Event Risk in Patients With Type 2 Diabetes

Abstract

Introduction: Muscle fitness is an established indicator of overall health. The power of muscle strength to predict cardiovascular endpoints in patients with type 2 diabetes mellitus (T2DM) is unclear and is addressed in the present study. Methods: We studied a high-risk cohort of 209 patients with T2DM who underwent coronary angiography for the evaluation of stable coronary artery disease (CAD). Forearm muscle dynamometry was performed to determine hand grip strength in the dominant arm the day before angiography. Significant CAD was diagnosed in the presence of coronary stenoses with lumen narrowing ≥50%. T2DM was diagnosed according to the ADA criteria. Prospectively, we recorded vascular events over 5.5±2.2 years. Results: Grip strength, measured in kilograms, at baseline did not differ significantly between patients with significant CAD and those who did not have significant CAD (34±12 vs. 31±12 kg; p=0.140). Prospectively, hand grip strength significantly predicted the incidence of major cardiovascular events (n=65) after adjustment for age, gender, BMI, smoking, systolic and diastolic blood pressure, LDL cholesterol and HDL cholesterol (standardized adjusted HR 0.72 [0.52-0.99]; p=0.042). This result was not attenuated after further adjustment for the angiographically determined baseline CAD state (HR 0.72 [0.53-0.99]; p=0.046). Conclusions: We conclude that hand grip strength in patients with T2DM is inversely associated with vascular events independently both from well established cardiovascular risk factors and from the angiographically determined baseline CAD state.