BMC Endocrine Disorders (Jul 2021)

Combined use of low T3 syndrome and NT-proBNP as predictors for death in patients with acute decompensated heart failure

  • Xinke Zhao,
  • Rongcheng Zhang,
  • Hugang Jiang,
  • Kai Liu,
  • Chengxu Ma,
  • Ming Bai,
  • Tao An,
  • Younan Yao,
  • Xinqiang Wang,
  • Ming Wang,
  • Yingdong Li,
  • Yuhui Zhang,
  • Jian Zhang

DOI
https://doi.org/10.1186/s12902-021-00801-x
Journal volume & issue
Vol. 21, no. 1
pp. 1 – 8

Abstract

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Abstract Background In patients with established HF, low triiodothyronine syndrome (LT3S) is commonly present, and N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a useful marker for predicting death. This study was aimed to evaluate the prognostic value of LT3S in combination with NT-proBNP for risk of death in patients with heart failure (HF). Methods A total of 594 euthyroid patients hospitalized with acute decompensated HF were enrolled by design. Of these patients, 27 patients died during hospitalization and 100 deaths were identified in patients discharged alive during one year follow-up. Patients were divided into 2 groups on the base of the reference ranges of free T3 (FT3) levels: LT3S group (FT3 < 2.3pg/mL, n = 168) and non-LT3S group (FT3 ≥ 2.3pg/mL, n = 426). Results In multivariable Cox regression, LT3S was significantly associated with 1 year all-cause mortality (adjusted hazard ratio, 1.85; 95 % confidence interval [CI], 1.21 to 2.82; P = 0.005), but not significant for in-hospital mortality (adjusted hazard ratio, 1.58; 95 % CI, 1.58 to 2.82; P = 0.290) after adjustment for clinical variables and NT-proBNP. Addition of LT3S and NT-proBNP to the prediction model with clinical variables significantly improved the C statistic for predicting 1 year all-cause mortality. Conclusions In patients with acute decompensated HF, the combination of LT3S and NT-proBNP improved prediction for 1 year all-cause mortality beyond established risk factors, but was not strong enough for in-hospital mortality.

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