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Persistence of mortality risk in patients with acute cardiac diseases and mild thyroid dysfunction

Sabrina Molinaro1, Giorgio Iervasi, Valentina Lorenzoni

  • 1Clinical Physiology Institute, National Council Research, Pisa, Italy.

The American Journal of the Medical Sciences
|August 31, 2011
PubMed

Insights

Mildly altered thyroid status in acute cardiac disease patients significantly increases cardiac and overall mortality risk. This elevated risk persists throughout the follow-up period, highlighting the prognostic importance of thyroid function.

Area of Science:

  • Cardiology
  • Endocrinology
  • Clinical Research

Background:

  • Limited research exists on the long-term prognostic implications of abnormal thyrotropin levels in acute cardiac disease patients.
  • Thyroid dysfunction is increasingly recognized as a potential contributor to cardiovascular outcomes.

Purpose of the Study:

  • To investigate the incidence and persistence of cardiac and overall mortality risk associated with abnormal thyrotropin values in patients with acute cardiac diseases.
  • To evaluate the long-term prognostic role of thyroid status in this patient population.

Main Methods:

  • A cohort of 1026 patients with acute cardiac diseases were categorized into four groups: euthyroid (EU), subclinical-like hypothyroidism (SLHYPO), subclinical-like hyperthyroidism (SLHYPER), and low-triiodothyronine syndrome (LowT3).
  • Patients were followed for a mean of 30 months to track cardiac and overall deaths.
  • Statistical analyses, including log-rank tests and adjusted hazard ratios, were employed to assess mortality risks.

Main Results:

  • Patients in the SLHYPO, SLHYPER, and LowT3 groups exhibited significantly lower survival rates for both cardiac and overall deaths compared to the euthyroid group.
  • After adjusting for risk factors, SLHYPO, SLHYPER, and LowT3 were associated with significantly higher hazard ratios for cardiac death.
  • Similarly, SLHYPO, SLHYPER, and LowT3 demonstrated increased hazard ratios for overall death, with the risks remaining proportional over time.

Conclusions:

  • Mildly altered thyroid status, including subclinical hypothyroidism, subclinical hyperthyroidism, and low-T3 syndrome, is linked to a substantially increased risk of mortality in patients with acute cardiac disease.
  • This elevated mortality risk is persistent and remains constant throughout the follow-up period.
  • Thyroid function assessment should be considered in the prognostic evaluation of patients with acute cardiac conditions.
Abstract

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