High quadriceps isometric strength reduces heart failure risk in ACS patients

A heightened level of quadriceps isometric strength (QIS) was significantly correlated with a reduced likelihood of experiencing heart failure following acute coronary syndrome (ACS), in a recent research published in European Journal of Preventive Cardiology.

The likelihood of heart failure (HF) post-acute coronary syndrome remains elevated. While attributes like coronary risk factors, cardiac and renal function are known risks, the connection between skeletal muscle strength, particularly quadriceps isometric strength, and HF development after ACS is not well-established. And so, Kensuke Ueno and team conducted this study to elucidate this relationship in ACS patients.

In this investigation, 1,053 ACS patients without pre-existing heart failure or HF-related complications during hospitalization were involved. Their median (IQR) age was 67 (57–74) years. These patients were categorized into two groups, high and low quadriceps isometric strength (QIS), based on gender-specific median QIS. The endpoint of the study was admissions due to heart failure.

Over an average follow-up duration of 4.4±3.7 years, there were 75 (7.1%) instances of heart failure admissions. Following adjustments for various factors, a high quadriceps isometric strength (QIS) was linked to a reduced risk of heart failure.

The HR (95% CI) per 5% increase in QIS for heart failure incidents was 0.87 (0.80–0.95). Even when considering competing risks like death, the outcomes remained consistent. The inclusion of QIS showed improvements in net reclassification (0.26; 95% CI, 0.002–0.52) and integrated discrimination index (0.01; 95% CI, 0.004–0.02) for heart failure.

The findings of this study indicate the advantage of evaluating skeletal muscle strength alongside fundamental characteristics, coronary risk factors, and cardiac and renal function when gauging the likelihood of heart failure following acute coronary syndrome.

Reference:

Kensuke Ueno, Kentaro Kamiya, Nobuaki Hamazaki, Kohei Nozaki, Takafumi Ichikawa, Masashi Yamashita, Shota Uchida, Takumi Noda, Takashi Miki, Kazuki Hotta, Emi Maekawa, Minako Yamaoka-Tojo, Atsuhiko Matsunaga, Junya Ako, Leg strength and incidence of heart failure in patients with acute coronary syndrome, European Journal of Preventive Cardiology, 2023; https://doi.org/10.1093/eurjpc/zwad406