Handgrip strength and mortality risk in myocardial infarction survivors: Data from NHANES 2011–2014

Handgrip strength (HGS) predicts adverse health outcomes, yet its association with mortality in myocardial infarction (MI) survivors remains incompletely characterized. This study examines correlations between HGS and cardiovascular/all-cause mortality in MI survivors. This cohort study used data from National Health and Nutrition Examination Survey. Multivariable-adjusted Cox proportional hazards models quantified associations of HGS (continuous and categorical) with mortality. Stratified and interaction analyses elucidated these relationships. Among 376 MI survivors (231 men and 145 women), each kilogram increase in HGS correlated with reduced all-cause mortality (hazard ratio [HR] 0.96, 95% confidence interval [CI] 0.95–0.98; P  < .001) and cardiovascular mortality (HR 0.95, 95% CI 0.93–0.97; P  < .001). Nondiabetic individuals in the highest HGS tertile demonstrated lower all-cause mortality (HR 0.10, 95% CI 0.04–0.24) and cardiovascular mortality (HR 0.02, 95% CI 0.00–0.16) versus the lowest tertile. Diabetic participants in the highest tertile exhibited reduced all-cause (HR 0.28, 95% CI 0.11–0.74; P  = .011) and cardiovascular mortality (HR 0.16, 95% CI 0.04–0.69; P  = .014). In this US national cohort of MI survivors, higher HGS was independently associated with lower all-cause and cardiovascular mortality, though the association was attenuated in individuals with diabetes. These findings highlight the prognostic value of muscular strength and underscore the need for trials to test whether strength-enhancing interventions, particularly in high-risk groups, can improve survival.