Prognostic value of free triiodothyronine and N-terminal pro-B-type natriuretic peptide for patients with acute myocardial infarction undergoing percutaneous coronary intervention: a prospective cohort study

Abstract

Background: Altered thyroid function and increased N-terminal pro-B-type natriuretic peptide (NT-proBNP) are prognostic factors in acute myocardial infarction (AMI). The study aims to investigate whether free triiodothyronine (fT3) and NT-proBNP are prognostic factors for long-term outcomes in patients with AMI undergoing percutaneous coronary intervention (PCI).Methods: This was an observational, prospective, single-center study of consecutive patients enrolled at Fuwai Hospital between January, 2013 and December, 2013. The patients were divided into two groups according to fT3 levels: low fT3 (<2.5 pg/mL) and normal fT3 (2.50-4.09 pg/mL). The primary outcome of this study was the incidence of major adverse cardiovascular events (MACEs).Results: There were 252 patients with low fT3 and 561 patients with normal fT3. After >2 years of follow-up, patients with low fT3 levels had higher rates of MACEs than those with normal fT3 (27.0% vs. 7.8%, P<0.001). Univariable Cox proportional hazards regression analyses showed that NT-proBNP >802.7 pg/mL [hazard ratio (HR) =5.063, 95% confidence interval (CI): 3.176-8.071, P<0.001] and fT3 <2.5 pg/mL (HR =3.867, 95% CI: 2.646-5.651, P<0.001) were the strongest predictors of MACEs.After adjustment for traditional risk predictors, fT3 <2.5 pg/mL (HR =2.570, 95% CI: 1.653-3.993, P<0.001) was one of the most important independent predictors of MACEs. Patients with NT-proBNP ≤802.7 pg/mL and fT3 ≥2.5 pg/mL had the best prognosis, while patients with NT-proBNP >802.7 pg/mL and fT3 <2.5 pg/mL had the worst outcomes (P<0.001).Conclusions: Low fT3 is a strong predictor of poor prognosis after AMI. The fT3+NT-proBNP combination might be a valuable predictor of the long-term outcomes of PCI after AMI.

Free triiodothyronine serves as a potential predictor of long-term heart failure following acute myocardial infarction

“…Patients with AMI tend to have low level of FT3, and severe cases even have low T3 syndrome [15]. A meta-analysis showed that low T3 syndrome is an independent risk factor for poor prognosis of cardiovascular diseases and associated with increased risks of all-cause death, cardiovascular death, and major adverse cardiovascular events (MACE) [ [19]. This study mainly observed the relationship between the FT3 level and the onset of long-term HF in AMI patients treated with and without PCI, and we found that low FT3 level was an independent risk factor for long-term HF in AMI patients and had a predictive value for the occurrence of long-term HF after AMI.…”

Association between dynamic fluctuations in triiodothyronine levels and prognosis among critically ill patients within comprehensive intensive care units

“…In comparison to these diverse scoring systems, a singular, rapid, and objective index holds advantages for disease severity assessment and prognosis. Abundant research underscores the association of free thyroid hormone T3 (FT3) with the prognosis of various conditions, including sepsis, heart failure, myocardial infarction, COVID-19, cardiomyopathy, liver failure associated with hepatitis B virus, and pulmonary arterial hypertension (5)(6)(7)(8)(9)(10)(11). FT3 has emerged as an independent prognostic indicator for ICU patients.…”