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Cited by 192Heart Failure Treatment and ManagementThyroid Disorders and TreatmentsHormonal and reproductive studies

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Triiodothyronine levels for risk stratification of patients with chronic heart failure

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Pingitore, Alessandro, Landi, Patrizia, Taddei, Maria Chiara, Ripoli, Andrea, L’Abbate, Antonio, Iervasi, Giorgio·2005·The American Journal of Medicine
DOI 10.1016/j.amjmed.2004.07.052
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Abstract

Purpose We sought to explore the use of triiodothyronine (T(3)) concentrations as an adjunct to clinical and functional parameters when estimating prognosis in patients with chronic heart failure.Methods We enrolled 281 patients with postischemic (n = 153) or nonischemic (n = 128) dilated cardiomyopathy. Total and free T(3) concentrations, and traditional clinical and functional cardiac parameters, were measured 2 to 5 days after hospital admission. A multivariate model was utilized to predict all-cause and cardiac mortality.Results All-cause mortality was 23% (n = 64) after a mean (+/-SD) of 12 +/- 7 months of follow-up; 47 (73%) of the patients died from cardiac causes. The mean ejection fraction was lower in those patients who died than in those who survived (26% +/- 8% vs. 31% +/- 8%, P < 0.001), as were levels of total T(3) (1.0 +/- 0.4 nmol/L vs. 1.3 +/- 0.3 nmol/L, P < 0.001) and free T(3) (3.2 +/- 1.4 pmol/L vs. 3.7 +/- 1.0 pmol/L, P < 0.001). In a multivariate model, ejection fraction (odds ratio [OR] = 2.0 per 10% decrease; 95% confidence interval [CI]: 1.4 to 2.8 per 10% decrease; P < 0.001) and total T(3) level (OR = 0.3 per 1-nmol/L increase; 95% CI: 0.1 to 0.5 per 1-nmol/L increase; P < 0.001) were the only independent predictors of all-cause mortality. In an alternative model using free T(3) levels, ejection fraction (OR = 1.9; 95% CI: 1.4 to 2.7; P < 0.001) and free T(3) level (OR = 0.6 per 1 pmol/L; 95% CI: 0.5 to 0.8 per 1 pmol/L; P <0.02) were associated with all-cause mortality. When we considered cardiac mortality alone, male sex (OR = 3.5; 95% CI: 1.7 to 13; P < 0.04), ejection fraction (OR = 1.7; 95% CI: 1.2 to 2.5; P < 0.006), and total T(3) level (OR = 0.3; 95% CI: 0.2 to 0.7; P < 0.002) were independent predictors with the multivariate model.Conclusion Low T(3) levels are an independent predictor of mortality in patients with chronic heart failure, adding prognostic information to conventional clinical and functional cardiac parameters.

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  1. Klein, 1998, Thyroid hormone treatment of congestive heart failure, Am J Cardiol, 81, 490
  2. Di Pierro, 1996, Improved cardiac output and enhanced cardiac mechanical efficiency with acute administration of T3, Ann Thorac Surg, 62, 662
  3. Ghione, 1997, Circulating cathecolamines, Intern Med, 5, 93

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Metadata

Authors
Pingitore, A., Landi, P., Taddei, M. C., Ripoli, A., L’Abbate, A., & Iervasi, G.
Affiliations
  • Istituto di Fisiologia Clinica (IT)
  • Scuola Superiore Sant'Anna (IT)
Corresponding author
Pingitore, Alessandro
ORCID
Venue
The American Journal of Medicine
Publisher
Elsevier BV
Published
2005-02
Volume
118
Issue
2
Pages
132-136
ISSN
0002-9343 (ISSN-L)
DOI
10.1016/j.amjmed.2004.07.052
OpenAlex
W2171564744
Cited by
192
References
25
Citations by year
2026: 2 · 2025: 1 · 2024: 6 · 2023: 9 · 2022: 5 · 2021: 9 · 2020: 12 · 2019: 11 · 2018: 9 · 2017: 10 · 2016: 10 · 2015: 10 · 2014: 6 · 2013: 9 · 2012: 9
FWCI
7.21
Type
journal article
Language
en
Open access
Licence
Locations
  • The American Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • CINECA IRIS Institutional Research Information System (Sant'Anna School of Advanced Studies) (submittedVersion, other-oa)
  • JAMA
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
Keywords
triiodothyronine, free triiodothyronine, chronic heart failure, dilated cardiomyopathy, risk stratification, prognosis, all-cause mortality, cardiac mortality, ejection fraction, thyroid hormones, non-ischemic cardiomyopathy, prognostic factors, multivariate risk models, NYHA functional class, NT-proBNP
MeSH terms
Aged, Aged, 80 and over, Chronic Disease, Female, Heart Failure, Humans, Male, Middle Aged, Prognosis, Stroke Volume, Triiodothyronine, Biomarkers, Multivariate Analysis, Survival Analysis, Myocardial Ischemia, Risk Assessment

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