Explanatory models of peripheral and respiratory muscle function based on cardiovascular risk factors in patients with acute coronary syndrome

Abstract

Introduction: Admissions to intensive care units (ICU) after an acute coronary syndrome (ACS) event are associated with several factors. To what extent musculoskeletal function upon ICU admission after an ACS event is related to cardiovascular disease (CVD) risk factors remains unknown. Objective: To explore the association of multiple risk factors with musculoskeletal function in adults with ACS admitted to the ICU. Methods: Sixty-nine inpatients (55 ± 6 years; 67% male) admitted to the ICU within <12h participated in this cross-sectional study. Participants were assessed regarding stress, smoking, alcoholism, hypertension, diabetes mellitus, and
obesity. The musculoskeletal function was assessed by predict values of handgrip strength of the dominant hand (HGS-D%) and maximal inspiratory and expiratory pressures (MIP% and MEP%, respectively). Results: After adjustment by age and sex,
drinking habits showed the strongest linear association with the total number of CVD risk factors [standardized ß, p-value] (ß = 0.110, p < 0.001), followed by smoking load (ß = 0.028, p = 0.009). Also, direct associations were observed for HGS-D% with mean
blood pressure (ß = 0.019 [0.001; 0.037], p = 0.048); MIP% with mean blood pressure (ß = 0.025 [0.006; 0.043], p = 0.013); and MEP% with drinking habits (ß = 0.009 [0.002; 0.016], p = 0.013) and body mass index (ß = 0.008 [0.000; 0.015], p = 0.035). Conclusion: Peripheral and respiratory muscle strength are directly associated with both comorbidities (hypertension, obesity) and health behaviors (drinking habits) in adults with ACS admitted to the ICU. Skeletal muscle strength measured at ICU admission should be interpreted in the context of its association with CVD risk factors in this population.