title: Prognostic Role of Hypothyroidism in Heart Failure: A Meta-Analysis.
abstract: Hypothyroidism is a risk factor of heart failure (HF) in the general population. However, the relationship between hypothyroidism and clinical outcomes in patients with established HF is still inconclusive.We conducted a systematic review and meta-analysis to clarify the association of hypothyroidism and all-cause mortality as well as cardiac death and/or hospitalization in patients with HF. We searched MEDLINE via PubMed, EMBASE, and Scopus databases for studies of hypothyroidism and clinical outcomes in patients with HF published up to the end of January 2015. Random-effects models were used to estimate summary relative risk (RR) statistics. We included 13 articles that reported RR estimates and 95% confidence intervals (95% CIs) for hypothyroidism with outcomes in patients with HF. For the association of hypothyroidism with all-cause mortality and with cardiac death and/or hospitalization, the pooled RR was 1.44 (95% CI: 1.29-1.61) and 1.37 (95% CI: 1.22-1.55), respectively. However, the association disappeared on adjustment for B-type natriuretic protein level (RR 1.17, 95% CI: 0.90-1.52) and in studies of patients with mean age <65 years (RR 1.23, 95% CI: 0.88-1.76).We found hypothyroidism associated with increased all-cause mortality as well as cardiac death and/or hospitalization in patients with HF. Further diagnostic and therapeutic procedures for hypothyroidism may be needed for patients with HF.
authors.affiliation: From the Department of Nuclear Medicine (NN), The Second Affiliated Hospital, Xi'an Jiaotong University School of Medicine, Xi'an, Shaanxi, P.R. China; Department of Cardiology (DG, RM, YZ, HK), The Second Affiliated Hospital, Xi'an Jiaotong University School of Medicine, Xi'an, Shaanxi, P.R. China; Endocrinology and Metabolic Diseases (VT), Interdisciplinary Department of Medicine, University of Bari, Bari, Italy; Cardiology Unit (MI), Department of Emergency and Organs Transplantation, University of Bari, Bari, Italy; and State University of New York Downstate Medical Center (JE), Brooklyn, NY.
authors.forename: Ning
authors.initials: N
authors.lastname: Ning
authors.forename: Dengfeng
authors.initials: D
authors.lastname: Gao
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Triggiani
authors.forename: Massimo
authors.initials: M
authors.lastname: Iacoviello
authors.forename: Judith E
authors.initials: JE
authors.lastname: Mitchell
authors.forename: Rui
authors.initials: R
authors.lastname: Ma
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhang
authors.forename: Huijuan
authors.initials: H
authors.lastname: Kou
mesh_terms: D002423:Cause of Death / Q000639:trends; D014943:Global Health; D006333:Heart Failure / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D007037:Hypothyroidism / Q000150:complications*; D011379:Prognosis; D012307:Risk Factors