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Predictive Value of Free Triiodothyronine in Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary
Zhi Qiang Yang1, Xiao Teng Ma1, Qiao Yu Shao1
1Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, 100029 Beijing, China.
Insights
Lower free triiodothyronine (FT3) levels are linked to increased major adverse cardiovascular events (MACE) in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). This finding highlights FT3 as a potential prognostic marker in ACS patients.
Area of Science:
- Cardiology
- Endocrinology
- Clinical Medicine
Background:
- Thyroid hormone homeostasis significantly impacts cardiovascular function.
- Acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) represent a critical population for cardiovascular risk assessment.
Purpose of the Study:
- To investigate the association between free triiodothyronine (FT3) levels and adverse cardiovascular outcomes.
- To determine if FT3 levels can predict major adverse cardiovascular events (MACE) in ACS patients post-PCI.
Main Methods:
- 1701 patients with ACS undergoing PCI were stratified into three groups based on FT3 tertiles.
- Major adverse cardiovascular events (MACE) were defined as a composite of all-cause death, ischemic stroke, myocardial infarction, or repeat revascularization.
- Multivariate Cox regression and non-linear association analyses were employed to assess the relationship between FT3 and MACE.
Main Results:
- Patients in the lowest FT3 tertile exhibited a significantly higher incidence of MACE, all-cause death, myocardial infarction, ischemic stroke, and repeat revascularization compared to the highest tertile.
- Lowest FT3 tertile was independently associated with a 92.9% higher risk of MACE (HR=1.929, p<0.001).
- A significant non-linear relationship was observed between FT3 levels and MACE, with FT3 tertiles improving MACE prediction (AUC=0.013, p=0.025).
Conclusions:
- Reduced free triiodothyronine (FT3) levels are independently associated with a worse prognosis in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI).
- FT3 may serve as a valuable prognostic biomarker for identifying high-risk ACS patients post-PCI.
Background:
Homeostasis of thyroid hormones has significant effects on the cardiovascular system. The aim of this study was to investigate the association between free triiodothyronine (FT3) and adverse cardiovascular events in patients with acute coronary syndrome (ACS) who were undergoing percutaneous coronary intervention (PCI).
Methods:
A total of 1701 patients with ACS undergoing PCI were included in this study. All patients were divided into three groups according to the tertiles of FT3 level: the lowest tertile (FT3 4.51 pmol/L), the middle tertile (4.51 pmol/L FT3 4.89 pmol/L) and the highest tertile group (FT3 4.89 pmol/L). The primary study endpoint was a composite of major adverse cardiovascular events (MACE), which included all-cause death, ischemic stroke, myocardial infarction, or unplanned repeat revascularization.
Results:
During a median follow-up period of 927 days, 349 patients had at least one event. Compared with patients with the highest tertile, those with the lowest tertile had a significantly higher incidence of MACE, all-cause death, MI, ischemic stroke and repeat revascularization (all p values 0.05). In the multivariate Cox regression analysis, the middle tertile had similar risk of MACE (HR = 0.986, 95% CI 0.728-1.336, p = 0.929) as the highest tertile, but the patients with the lowest tertile had a 92.9% higher risk of MACE (HR = 1.929, 95% CI 1.467-2.535, p 0.001). There was a non-linear relationship between FT3 and MACE and unplanned repeat revascularization (all p values for non-linear association 0.001). Adding the tertiles of FT3 level into the baseline model yielded a significant improvement in discrimination for predicting MACE ( AUC = 0.013, p = 0.025).
Conclusions:
A significantly reduced FT3 level was independently associated with a worse prognosis in patients with ACS undergoing PCI.
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