Predicting major cardiac and cerebrovascular events in acute coronary syndrome patients using the thyroid hormone
Hui He1,2, Jun Wang1, Long Xia3
1Department of Cardiology, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, China.
Insights
Thyroid hormone sensitivity indices predict adverse events in acute coronary syndrome patients undergoing percutaneous coronary intervention. Parametric thyroid feedback quantile-based index (PTFQI) showed the highest predictive value for major adverse cardiac and cerebrovascular events (MACCEs).
Area of Science:
- Cardiology
- Endocrinology
- Medical Diagnostics
Background:
- Thyroid hormone sensitivity indices offer novel insights into thyroid function in cardiovascular diseases.
- The predictive capability of these indices for adverse events post-percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS) patients is currently unknown.
Purpose of the Study:
- To evaluate the predictive value of thyroid sensitivity indices for major adverse cardiac and cerebrovascular events (MACCEs) in ACS patients undergoing PCI.
Main Methods:
- Analysis of 431 ACS patients undergoing PCI.
- Calculation of thyroid hormone sensitivity indices: thyroid-stimulating hormone index (TSHI), thyrotrophic thyroxine resistance index (TT4RI), thyroid feedback quantile-based index (TFQI), and parametric thyroid feedback quantile-based index (PTFQI).
- Multivariate Cox regression and ROC curve analysis to assess MACCE prediction.
Main Results:
- All four indices (TSHI, TT4RI, TFQI, PTFQI) independently predicted MACCEs.
- PTFQI demonstrated the highest predictive accuracy (AUROC = 0.688).
- Incorporating PTFQI into the GRACE score significantly improved MACCE risk prediction (AUROC = 0.759).
- PTFQI showed greater predictive value in males and patients with abnormal blood glucose.
Conclusions:
- Thyroid hormone sensitivity indices are linked to an increased risk of MACCEs in ACS patients post-PCI.
- PTFQI is a valuable tool for enhancing MACCE risk stratification in this patient population.
Background And Aim:
The thyroid hormone sensitivity index provides a new perspective for investigating nuanced alterations in thyroid function in cardiovascular disorders. However, the predictive value of thyroid hormone sensitivity indices for adverse events following percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS) patients remains unknown. This study aimed to investigate the predictive value of thyroid sensitivity indices for major adverse cardiac and cerebrovascular events (MACCEs) in these patients.
Methods And Results:
A total of 431 patients were included in the analysis. Thyroid hormone sensitivity indices were calculated using the thyroid-stimulating hormone index (TSHI), thyrotrophic thyroxine resistance index (TT4RI), thyroid feedback quantile-based index (TFQI), and parametric thyroid feedback quantile-based index (PTFQI). During the median follow-up period, 50 (11.60%) patients experienced MACCEs. Multivariate Cox regression analysis revealed that TSHI (HR 1.277, 95% CI 1.110-1.468, P<0.001), TT4RI (HR 1.002, 95% CI 1.001-1.003, P<0.001), TFQI (HR 1.130, 95% CI 1.043-1.224, P=0.003), and PTFQI (HR 1.237, 95% CI 1.107-1.383, P<0.001) were independent predictors of MACCEs. The area under the ROC curve (AUROC) revealed that PTFQI had the highest predictive value (AUROC =0.688, 95% CI: 0.595-0.780; P < 0.001). Adding PTFQI to the GRACE score can enhance the risk prediction of MACCEs in ACS patients undergoing PCI, AUROC = 0.759 (95% CI 0.676-0.842, P < 0.001) vs AUROC = 0.646 (95% CI 0.563-0.729, P = 0.001), and there is a significant difference (P = 0.0108). Subgroup analysis indicated that PTFQI had a more significant predictive value for MACCEs in males and patients with abnormal blood glucose.
Conclusion:
Thyroid hormone sensitivity indices are associated with a greater risk of MACCEs in patients with ACS following PCI.
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