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Thyroid function in heart failure and impact on mortality

Judith E Mitchell, Anne S Hellkamp, Daniel B Mark

    JACC. Heart Failure
    |October 26, 2013
    PubMed

    Insights

    Patients with heart failure (HF) and abnormal thyroid function face a significantly higher risk of death. This includes both hypothyroidism and hyperthyroidism, even after accounting for other risk factors.

    Area of Science:

    • Cardiology
    • Endocrinology
    • Clinical Research

    Background:

    • Thyroid hormone homeostasis is crucial for cardiovascular function.
    • The independent prognostic impact of thyroid dysfunction in heart failure (HF) patients remains unclear.

    Purpose of the Study:

    • To determine if patients with systolic heart failure (HF) and abnormal thyroid function have an increased risk of mortality.
    • To investigate the prognostic significance of thyroid abnormalities in HF.

    Main Methods:

    • Utilized data from the Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT).
    • Measured thyroid-stimulating hormone (TSH) at baseline and every 6 months in 2,225 HF patients over 5 years.
    • Compared mortality rates between patients with normal and abnormal thyroid function.

    Main Results:

    • 13% of HF patients had abnormal TSH levels at baseline (12% hypothyroid, 1% hyperthyroid).
    • Amiodarone treatment increased the risk of developing abnormal TSH levels.
    • Both baseline and new-onset hypothyroidism and hyperthyroidism were associated with significantly higher mortality (HR 1.58 for hypo, HR 1.85 for hyper).

    Conclusions:

    • Abnormal thyroid function is a significant independent predictor of mortality in symptomatic HF patients with reduced ejection fraction.
    • These findings highlight the importance of monitoring thyroid function in heart failure management.
    Abstract

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