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Cited by 285Thyroid Disorders and TreatmentsThyroid and Parathyroid SurgeryHormonal and reproductive studies

Association between increased mortality and mild thyroid dysfunction in cardiac patients

Open access
Iervasi, Giorgio·2007·Archives of Internal Medicine
DOI 10.1001/archinte.167.14.1526
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Abstract

BACKGROUND: The effects of subclinical thyroid dysfunction on cardiac outcome are not well defined. METHODS: To assess the relationship between mild thyroid dysfunction and the incidence of death in cardiac patients, we evaluated 3121 cardiac patients. Cardiac and overall deaths were considered. Four groups were defined: euthyroidism, subclinical hypothyroidism (SCH), subclinical hyperthyroidism (SCT), and low triiodothyronine syndrome (low T3). RESULTS: After mean follow-up of 32 months, there were 65 and 140 cardiac and overall deaths (3.4% and 7.3%), respectively, in euthyroidism, 15 and 27 (7.2% and 13.0%) in SCH, 8 and 9 (8.2% and 9.2%) in SCT, and 59 and 119 (6.5% and 13.1%) in low T3. Survival rates for cardiac death were lower in SCH, SCT, and low T3 than in euthyroidism (log-rank test; chi2 = 19.46; P < .001). Survival rates for overall death were lower in SCH and low T3 than in euthyroidism (log-rank test; chi2 = 26.67; P < .001). After adjustment for several risk factors, hazard ratios (HRs) for cardiac death were higher in SCH (HR, 2.40; 95% confidence interval [CI], 1.36-4.21; P = .02), SCT (HR, 2.32; 95% CI, 1.11-4.85; P = .02), and low T(3) (HR, 1.63; 95% CI, 1.14-2.33; P = .007) than in euthyroidism; HRs for overall death were higher in SCH (HR, 2.01; 95% CI, 1.33-3.04; P < .001) and low T3 (HR, 1.57; 95% CI, 1.22-2.01; P < .001) but not in SCT. CONCLUSION: A mildly altered thyroid status is associated with an increased risk of mortality in patients with cardiac disease.

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Authors
Iervasi, G.
Affiliations
Istituto di Fisiologia Clinica (IT)
Corresponding author
Iervasi, Giorgio
ORCID
Iervasi, Giorgio
Venue
Archives of Internal Medicine
Publisher
American Medical Association (AMA)
Published
2007-07-23
Volume
167
Issue
14
Pages
1526
ISSN
0003-9926 (ISSN-L)
DOI
10.1001/archinte.167.14.1526
OpenAlex
W2110352248
Cited by
285
References
25
Citations by year
2026: 1 · 2025: 5 · 2024: 11 · 2023: 7 · 2022: 15 · 2021: 14 · 2020: 24 · 2019: 14 · 2018: 22 · 2017: 17 · 2016: 14 · 2015: 12 · 2014: 24 · 2013: 23 · 2012: 21
FWCI
10.23
Type
journal article
Language
en
Open access
Licence
other-oa
Locations
  • Archives of Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • CINECA IRIS Institutional Research Information System (Sant'Anna School of Advanced Studies) (submittedVersion, other-oa)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Surgery › Thyroid and Parathyroid Surgery
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
Keywords
subclinical hypothyroidism, subclinical hyperthyroidism, low triiodothyronine syndrome, thyroid dysfunction, cardiac mortality, all-cause mortality, cardiac patients, survival, euthyroidism, cardiovascular risk factors, thyroid hormones, mortality risk factors, mortality prediction model, risk stratification
MeSH terms
Coronary Disease, Female, Follow-Up Studies, Humans, Hyperthyroidism, Hypothyroidism, Male, Middle Aged, Mortality, Triiodothyronine, Survival Rate, Proportional Hazards Models

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