Association of Thyroid Hormone Levels and Thyroid Hormone Sensitivity with Adverse Clinical Outcomes in Euthyroid Patients with Ischemic Stroke

This research assessed the effects of thyroid hormone levels and sensitivity on unfavorable clinical outcomes in euthyroid ischemic stroke patients.

This study enrolled 4409 euthyroid stroke patients from Minhang Hospital, measured their serum thyroid hormone levels, and calculated their thyroid hormone sensitivity. The 3- month primary outcome comprised death or major disability (modified Rankin Scale [mRS] score ≥ 3).

Over the 3-month follow-up period, 1292 participants (29.30%) experienced the primary outcome. In adjusted models, the highest quartiles of Free Triiodothyronine (FT3) and Free Thyroxine Ratio (FT3/FT4) were associated with reduced odds of the primary outcome (ORs = 0.60 [95% CI: 0.47-0.77] and 0.70 [95% CI: 0.54-0.90], respectively; both Ptrend < 0.007). Significant linear dose-response correlations were detected between serum FT3, FT3/FT4, and adverse outcomes (both P for linearity < 0.001).

Higher baseline levels of FT3 and the FT3/FT4 ratio were associated with a favorable prognosis among euthyroid patients with ischemic stroke, and might serve as potential prognostic biomarkers for ischemic stroke.

Elevated FT3 and peripheral thyroid hormone sensitivity were independent predictors of reduced risk for 3-month adverse outcomes in euthyroid ischemic stroke patients.