Subclinical thyroid dysfunction is associated with adverse prognosis in heart failure patients with reduced ejection fraction
Open accessAbstract
Subclinical thyroid dysfunction whose typical patterns include subclinical hypothyroidism and subclinical hyperthyroidism, has been indicated to be associated with an increased risk of heart failure (HF). However, the relationship between subclinical thyroid dysfunction and the clinical outcomes of HF patients is uncertain. This meta-analysis was conducted to assess the association between subclinical thyroid dysfunction and the clinical outcomes of HF patients. Pubmed, Embase, Web of Science and Cochrane Central Register of Clinical Trials were searched for eligible studies published up to August 1, 2018 which reported the association between subclinical thyroid dysfunction and the clinical outcomes of HF patients. The pooled hazard ratio (HR) with the corresponding 95% confidence interval (CI) was used to assess the association. Fourteen studies met the eligibility criteria and a total of 21,221 patients with heart failure were included in the meta-analysis. Compared with HF patients with euthyroidism, the pooled HR of subclinical hypothyroidism for all-cause mortality was 1.45 (95% CI 1.26–1.67) in a randomized effects model with mild heterogeneity (I 2 = 40.1, P = 0.073). The pooled HR of subclinical hypothyroidism for cardiac death and/or hospitalization was 1.33 (1.17–1.50) in a randomized effects model with moderate heterogeneity (I 2 = 69.4, P < 0.001). Subclinical hyperthyroid can increase the risk of all-cause mortality without heterogeneity (HR 1.31, 95% CI 1.10–1.55, I 2 = 25.5%, P = 0.225) but have no influence on the risk of cardiac death and/or hospitalization (HR 1.03, 95% CI 0.87–1.23, I 2 = 0.0%, P = 0.958). These significant adverse associations were also retained in subgroup analysis. Sensitivity analysis demonstrated the stability of the results of our meta-analysis. Both subclinical hypothyroidism and subclinical hyperthyroidism are associated with adverse prognosis in patients with HF. Subclinical thyroid dysfunction may be a useful and promising predictor for the long-term prognosis in HF patients.
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In patients with heart failure, subclinical hypothyroidism is associated with a significantly increased risk of all-cause mortality compared to euthyroid patients.
“The meta-analysis, including 21 studies and 46,302 patients, showed that SC-HT was associated with a significantly increased risk of all-cause mortality and cardiovascular events compared to euthyroid patients in this specific, high-risk population [30].”
From Thyroid and heart, a clinically relevant relationship (2021) · cites this paper as [30]
In patients with heart failure, subclinical hypothyroidism is associated with a significantly increased risk of cardiovascular events compared to euthyroid patients.
“The meta-analysis, including 21 studies and 46,302 patients, showed that SC-HT was associated with a significantly increased risk of all-cause mortality and cardiovascular events compared to euthyroid patients in this specific, high-risk population [30].”
From Thyroid and heart, a clinically relevant relationship (2021) · cites this paper as [30]
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- Authors
- Yang, G., Wang, Y., Ma, A., & Wang, T.
- Affiliations
- First Affiliated Hospital of Xi'an Jiaotong University (CN)
- Corresponding author
- Ma, Aiqun
- Wang, Tingzhong
- Venue
- BMC Cardiovascular Disorders
- Published
- 2019-04-04
- Volume
- 19
- Issue
- 1
- Pages
- 83-83
- ISSN
- 1471-2261 (ISSN-L)
- PMC
- PMC6450005
- OpenAlex
- W2947558834
- Cited by
- 51
- References
- 56
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 7 · 2023: 10 · 2022: 9 · 2021: 16 · 2020: 5 · 2019: 1
- FWCI
- 1.19
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Cardiovascular Disorders (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Science and Technology Program for Public Wellbeing of China (2012GS610101)
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Thyroid Disorders and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- subclinical thyroid dysfunction, subclinical hypothyroidism, subclinical hyperthyroidism, heart failure, reduced ejection fraction, all-cause mortality, cardiovascular mortality, hospitalization, prognosis, thyroid function
- MeSH terms
- Aged, Cause of Death, Female, Heart Failure, Humans, Hyperthyroidism, Hypothyroidism, Male, Middle Aged, Prognosis, Risk Factors, Stroke Volume, Thyroid Gland, Time Factors, Ventricular Function, Left, Risk Assessment, Asymptomatic Diseases
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