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Zhao X, Zhang R, Jiang H, Liu K, Ma C, Bai M, An T, Yao Y, Wang X, Wang M, Li Y, Zhang Y, Zhang J. Combined use of low T3 syndrome and NT-proBNP as predictors for death in patients with acute decompensated heart failure. BMC Endocr Disord 2021; 21:140. [PMID: 34215247 PMCID: PMC8252209 DOI: 10.1186/s12902-021-00801-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 06/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In 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). METHODS A 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). RESULTS In 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. CONCLUSIONS In 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.
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Affiliation(s)
- Xinke Zhao
- 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
| | - Rongcheng Zhang
- 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
| | - Hugang Jiang
- Department of Cardiology, Affiliated Hospital of Gansu University of Chinese Medicine, 732 Jiyuguanxi Road, 730000, Lanzhou, China
| | - Kai Liu
- Department of Cardiology, Affiliated Hospital of Gansu University of Chinese Medicine, 732 Jiyuguanxi Road, 730000, Lanzhou, China
| | - Chengxu Ma
- Department of Cardiology, Affiliated Hospital of Gansu University of Chinese Medicine, 732 Jiyuguanxi Road, 730000, Lanzhou, China
| | - Ming Bai
- Department of Cardiology, The First Hospital of Lanzhou University, 730000, Lanzhou, China
| | - Tao An
- 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
| | - Younan Yao
- 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
| | - Xinqiang Wang
- Department of Cardiology, Affiliated Hospital of Gansu University of Chinese Medicine, 732 Jiyuguanxi Road, 730000, Lanzhou, China
| | - Ming Wang
- Department of Cardiology, Affiliated Hospital of Gansu University of Chinese Medicine, 732 Jiyuguanxi Road, 730000, Lanzhou, China
| | - Yingdong Li
- Department of Cardiology, Affiliated Hospital of Gansu University of Chinese Medicine, 732 Jiyuguanxi Road, 730000, Lanzhou, China.
| | - Yuhui Zhang
- 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.
| | - Jian Zhang
- 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.
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