The relationship and prognostic impact of low-T3 syndrome and NT-pro-BNP in cardiovascular patients.
OBJECTIVE
Low-T3 syndrome is highly prevalent and independently prognostic in cardiovascular patients. The relationship and prognostic impact with the cardiac marker NT-pro-BNP have not been thoroughly investigated.


METHODS
Thyroid hormone levels and NT-pro-BNP were assessed in 615 consecutive patients hospitalized for cardiovascular disease. Patients with primary overt or latent thyroid disorder, hormone replacement, thyreostatic and amiodarone therapy were excluded. The association with and predictive impact on mortality were examined.


RESULTS
36 (7.1%) patients had low-T3 syndrome. After adjustment for known confounders, NT-pro-BNP was significantly associated with fT3 and low-T3 syndrome. fT3 (HR 0.58, 95%CI 0.34-0.98) and low-T3 syndrome (HR 3.0, 95%CI 1.4-6.3) were predictive for mortality after adjustment for NT-pro-BNP levels and other cardiovascular prognostic variables. In patients with fT3 levels within the normal range, fT3 and NT-pro-BNP stratified by median values showed complementary prognostic information with the highest risk for mortality in patients with low normal fT3 and high NT-pro-BNP (HR 10.5, 95%CI 3.2-34.6).


CONCLUSIONS
fT3 and low-T3 syndrome are significantly related to NT-pro-BNP in patients with cardiovascular disease, but are predictors of mortality independently of NT-pro-BNP and other known cardiovascular risk parameters.
Department III of Internal Medicine, Herzzentrum, University of Cologne, Kerpenerstr. 62, 50937 Cologne, Germany. roman.pfister@uk-koeln.de
Roman
R
Pfister
Nicole
N
Strack
Klaus
K
Wielckens
Gebhart
G
Malchau
Erland
E
Erdmann
Christian A
CA
Schneider
D000368:Aged; D002318:Cardiovascular Diseases / Q000097:blood* / Q000150:complications* / Q000401:mortality; D005067:Euthyroid Sick Syndromes / Q000097:blood* / Q000150:complications* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D013963:Thyroid Hormones / Q000097:blood
D010446:Peptide Fragments; D013963:Thyroid Hormones; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain