Long-term influence of subclinical thyroid dysfunction on acute heart failure patients

Abstract

Objective To evaluate the long-term influence of subclinical thyroid dysfunction on acute heart failure (AHF) patients. Methods A total of 420 AHF patients were enrolled in this study.Thyroid function, B-brain natriuretic peptide (BNP) and echocardiogram were tested within 24 h after admission.Relationship between subclinical thyroid dysfunction and all-cause death was analyzed by Logistic regression and Cox risk model. Results During follow-up time of 6~49 months, 119 patients(28.3%)died.All-cause mortality was significantly different between euthyroidism group, subclinical hypothyroidism (SHypo)group and subclinical hyperthyroidism (SHyper) group(26.5%, 51.1% and 34.5%, respectively, log-rank χ2=6.172, P=0.046). The multivariate Cox hazard analysis demonstrated that age, BNP, left ventricular ejection fractions, thyroxine, free thyroxine, and SHypo (hazard ratio: 1.147, 95% CI: 0.971-1.352, P=0.012) were predictors of all-cause mortality.While triiodothyronine, free triiodothyronine and SHper were not predictors of all-cause mortality. Conclusions SHypo is an independent predictor for long-term all-cause mortality among AHF patients.SHper does not show the predictive value. Key words: Heart failure; Subclinical thyroid dysfunction; Prognosis