Combined use of low T3 syndrome and NT-proBNP as predictors for death in patients with acute decompensated heart failure

BMC Endocrine Disorders

Chengxu Ma¹  Hugang Jiang¹  Yingdong Li¹  Ming Wang¹  Kai Liu¹  Xinqiang Wang¹  Ming Bai²  Xinke Zhao³  Yuhui Zhang³  Tao An³  Jian Zhang³  Rongcheng Zhang³  Younan Yao³ 

[1] Department of Cardiology, Affiliated Hospital of Gansu University of Chinese Medicine, 732 Jiyuguanxi Road, 730000, Lanzhou, China;Department of Cardiology, The First Hospital of Lanzhou University, 730000, Lanzhou, China;Heart Failure Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, 167 Beilishi Road, 100037, Beijing, China;

关键词: Acute decompensated heart failure;    Low T3 syndrome;    NT-proBNP;    Mortality;   

DOI  :  10.1186/s12902-021-00801-x

来源: Springer

【 摘 要 】

BackgroundIn patients with established HF, low triiodothyronine syndrome (LT3S) is commonly present, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a useful marker for predicting death. This study was aimed to evaluate the prognostic value of LT3S in combination with NT-proBNP for risk of death in patients with heart failure (HF).MethodsA total of 594 euthyroid patients hospitalized with acute decompensated HF were enrolled by design. Of these patients, 27 patients died during hospitalization and 100 deaths were identified in patients discharged alive during one year follow-up. Patients were divided into 2 groups on the base of the reference ranges of free T3 (FT3) levels: LT3S group (FT3 < 2.3pg/mL, n = 168) and non-LT3S group (FT3 ≥ 2.3pg/mL, n = 426).ResultsIn multivariable Cox regression, LT3S was significantly associated with 1 year all-cause mortality (adjusted hazard ratio, 1.85; 95 % confidence interval [CI], 1.21 to 2.82; P = 0.005), but not significant for in-hospital mortality (adjusted hazard ratio, 1.58; 95 % CI, 1.58 to 2.82; P = 0.290) after adjustment for clinical variables and NT-proBNP.Addition of LT3S and NT-proBNP to the prediction model with clinical variables significantly improved the C statistic for predicting 1 year all-cause mortality.ConclusionsIn patients with acute decompensated HF, the combination of LT3S and NT-proBNP improved prediction for 1 year all-cause mortality beyond established risk factors, but was not strong enough for in-hospital mortality.

【 授权许可】

CC BY