title: Long-term prognostic value of triiodothyronine concentration in elderly patients with heart failure.
abstract: In this study the authors sought to determine the prevalence and long-term prognostic value of low triiodothyronine levels in elderly patients with heart failure and no thyroid disease. Lower levels of triiodothyronine are more prevalent in patients with advanced heart failure without thyroid disease, and this may have prognostic implications. However, this hormonal milieu has not been investigated in elderly patients. The authors prospectively followed a consecutive sample of 69 elderly patients aged 76.5+/-5.9 years with heart failure and 44 age-matched controls without heart failure between March 1997 and September 2000 at the Geriatric Cardiology Outpatient Clinic of the Heart Institute of Sao Paulo, Brazil. Events analyzed included death, hospitalization, and the combined end point of death or hospitalization. The study revealed that levels of triiodothyronine were lower in heart failure patients than in controls (89+/-23 vs. 101+/-16 ng/dL, p=0.001). During the follow-up period of 14.3+/-8.1 months there were 19 deaths and 33 hospitalizations in the heart failure group. The combined end point of death or hospitalization occurred in 38 patients. Triiodothyronine levels were lower in heart failure patients who had a cardiovascular event than in event-free patients (82.7+/-24.8 vs. 96.7+/-19.2 ng/dL, p=0.012). The odds ratio for events was 9.8 (95% confidence interval, 2.2-43, p=0.004) for patients in the lowest tertile of triiodothyronine, that is, lower than 80 ng/dL, compared with patients with levels above 80 ng/dL. The authors conclude that among elderly patients with heart failure, lower triiodothyronine concentrations are more prevalent and are associated with a worse prognosis.
authors.affiliation: Division of Geriatric Cardiology, Heart Institute (InCor), University of Sao Paulo Medical School, Sao Paolo, Brazil.
authors.forename: Jairo
authors.initials: J
authors.lastname: Rays
authors.forename: Mauricio
authors.initials: M
authors.lastname: Wajngarten
authors.forename: Otavio C E
authors.initials: OC
authors.lastname: Gebara
authors.forename: Amit
authors.initials: A
authors.lastname: Nussbacher
authors.forename: Renata Martinho
authors.initials: RM
authors.lastname: Telles
authors.forename: Humberto
authors.initials: H
authors.lastname: Pierri
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Rosano
authors.forename: João Batista
authors.initials: JB
authors.lastname: Serro-Azul
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002303:Cardiac Output, Low / Q000097:blood* / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000097:blood* / Q000401:mortality*; D006760:Hospitalization; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate; D013997:Time Factors; D014284:Triiodothyronine / Q000097:blood*
chemical_list: D014284:Triiodothyronine