Prognostic value of free triiodothyronine in patients with dilated cardiomyopathy.
Prognostic value of free triiodothyronine in patients with dilated cardiomyopathy.
复制标题
游离三碘甲状腺原氨酸对扩张型心肌病患者的预后价值
DOI：
10.1097/cm9.0000000000000896
复制
发表时间：
2020-09-20
影响因子：
6.1
通讯作者：
Zhang FX
中科院分区：
文献类型：
--
作者：
Zhao HY;Sun L;Zhu YQ;Chen QS;Zhu WW;Toorabally MB;Chen XG;Zhang FX
游离三碘甲状腺原氨酸（FT 3）与扩张型心肌病（DCM）患者长期预后的关系尚未得到评估。本研究的目的是确定FT 3水平是否可以提供DCM患者的预后价值。方法收集2009年10月至2014年12月连续收治的DCM患者的临床资料。采用荧光免疫法测定FT 3。同时检测其他生化指标，如游离甲状腺素（FT 4）、促甲状腺激素、红细胞、血红蛋白、血尿素氮和血清肌酐。每3个月进行一次随访。主要终点为全因死亡率。Pearson分析FT 3等指标与DCM患者预后的相关性。采用考克斯风险模型比较DCM和FT 3的长期死亡率之间的关系。结果收集到176例DCM患者的临床资料。其中，24例患者错过了FT 3值，6例患者失访。共分析了146例患者的资料。中位随访时间为79.9（53.5-159.6）个月，9例患者失访，61例患者死亡（非生存组），85例患者存活（生存组）。死亡组FT 3显著低于存活组（3.65 ± 0.83 pmol/L vs.4.36 ± 1.91 pmol/L; P = 0.003）。 FT 3与红细胞、血红蛋白呈显著正相关，与年龄、尿素氮、肌酐呈显著负相关（P <0.05）。 FT 3水平较低组（FT 3 ≤3.49 pmol/L）患者的全因死亡风险较高（对数秩P = 0.001）。 在多变量考克斯回归分析中，FT 3水平与全因死亡率显著相关（风险比：0.70，95%置信区间0.52-0.95，趋势P = 0.021）。 结论低水平的FT 3与DCM患者的全因死亡率增加有关。
Abstract Background The association between free triiodothyronine (FT3) and long-term prognosis in dilated cardiomyopathy (DCM) patients has not been evaluated. The purpose of this study was to determine whether the level of FT3 could provide prognostic value in patients with DCM. Methods Data of consecutive patients diagnosed with DCM were collected from October 2009 to December 2014. FT3 was measured by fluoroimmunoassay. Other biochemical markers, such as free thyroxin (FT4), thyroid-stimulating hormone, red blood cell, hemoglobin, blood urea nitrogen, and serum creatinine, were tested at the same time. Follow-up was performed every 3 months. The primary endpoint was all-cause mortality. Pearson analysis was used to evaluate the correlation of FT3 and other lab metrics with DCM patients’ prognosis. The association of long-term mortality in DCM and FT3 was compared using Cox hazards model. Results Data of 176 patients diagnosed with DCM were collected. Of them, 24 patients missed FT3 values and six patients were lost to follow-up. Altogether, data of 146 patients were analyzed. During the median follow-up time of 79.9 (53.5–159.6) months, nine patients lost, 61 patients died (non-survival group), and 85 patients survived (survival group). FT3 was significantly lower in non-survival group than that in survival group (3.65 ± 0.83 pmol/L vs. 4.36 ± 1.91 pmol/L; P = 0.003). FT3 also showed a significantly positive correlation with red blood cell and hemoglobin, negatively correlated with age, blood urea nitrogen and serum creatinine (P < 0.05), respectively. Patients in the group of lower FT3 levels (FT3 ≤3.49 pmol/L) suffered from a higher risk of all-cause mortality (P for log-rank = 0.001). In multivariate Cox regression analysis, FT3 level was significantly associated with all-cause mortality (hazard ratio: 0.70, 95% confidence interval 0.52–0.95, P for trend = 0.021). Conclusion Low levels of FT3 were associated with increased all-cause mortality in patients with DCM.