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Cited by 472Thyroid Disorders and TreatmentsHormonal and reproductive studiesHeart Failure Treatment and Management

Low-T3 syndrome: a strong prognostic predictor of death in patients with heart disease

Iervasi, Giorgio, Pingitore, Alessandro, Landi, Patrizia, Raciti, Mauro, Ripoli, Andrea, Scarlattini, Maria, L’Abbate, Antonio, Donato, Luigi·2003·Circulation
DOI 10.1161/01.cir.0000048124.64204.3f
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Abstract

BACKGROUND: Clinical and experimental data have suggested a potential negative impact of low-T3 state on the prognosis of cardiac diseases. The aim of the present prospective study was to assess the role of thyroid hormones in the prognosis of patient population with heart disease. METHODS AND RESULTS: A total of 573 consecutive cardiac patients underwent thyroid function profile evaluation. They were divided in two subgroups: group I, 173 patients with low T3, ie, with free T3 (fT3) <3.1 pmol/L, and group II, 400 patients with normal fT3 (>or=3.1 pmol/L). We considered cumulative and cardiac death events. During the 1-year follow-up, there were 25 cumulative deaths in group I and 12 in group II (14.4% versus 3%, P<0.0001); cardiac deaths were 13 in group I and 6 in group II (7.5% versus 1.5%, P=0.0006). According to the Cox model, fT3 was the most important predictor of cumulative death (hazard ratio [HR] 3.582, P<0.0001), followed by dyslipidemia (HR 2.955, P=0.023), age (HR 1.051, P<0.005), and left ventricular ejection fraction (HR 1.037, P=0.006). At the logistic multivariate analysis, fT3 was the highest independent predictor of death (HR 0.395, P=0.003). A prevalence of low fT3 levels was found in patients with NYHA class III-IV illness compared with patients with NYHA class I-II (chi(2) 5.65, P=0.019). CONCLUSIONS: Low-T3 syndrome is a strong predictor of death in cardiac patients and might be directly implicated in the poor prognosis of cardiac patients.

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  • In patients with chronic heart failure, nonthyroidal illness has been associated with a worse prognosis.

    “in patients with chronic HF, NTI has been associated with a worse prognosis (96,124,125).”

    From Thyroid Hormones and Cardiovascular Function and Diseases (2018) · cites this paper as [125]

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Authors
Iervasi, G., Pingitore, A., Landi, P., Raciti, M., Ripoli, A., Scarlattini, M., L’Abbate, A., & Donato, L.
Affiliations
Istituto di Fisiologia Clinica (IT)
ORCID
Venue
Circulation
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2003-02-11
Volume
107
Issue
5
Pages
708-713
ISSN
  • 0009-7322 (ISSN-L)
  • 1524-4539
DOI
10.1161/01.cir.0000048124.64204.3f
OpenAlex
W2041509950
Cited by
472
References
32
Citations by year
2026: 16 · 2025: 14 · 2024: 16 · 2023: 14 · 2022: 27 · 2021: 19 · 2020: 24 · 2019: 30 · 2018: 26 · 2017: 21 · 2016: 26 · 2015: 23 · 2014: 23 · 2013: 22 · 2012: 21
FWCI
9.16
Type
journal article
Language
en
Open access
closed
Locations
  • Circulation (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal and reproductive studies
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
Keywords
low T3 syndrome, free T3, thyroid hormones, heart disease, prognosis, mortality, cardiovascular mortality, dyslipidemia, NYHA functional class, left ventricular ejection fraction, prognostic factors
MeSH terms
Aged, Female, Follow-Up Studies, Heart Diseases, Humans, Hyperlipidemias, Male, Middle Aged, Predictive Value of Tests, Prognosis, Prospective Studies, Stroke Volume, Syndrome, Thyroid Function Tests, Thyrotropin, Thyroxine, Triiodothyronine, Survival Rate, Multivariate Analysis, Logistic Models, Proportional Hazards Models

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