title: Usefulness of Serum Triiodothyronine (T3) to Predict Outcomes in Patients Hospitalized With Acute Heart Failure.
abstract: Thyroid hormone plays an important role in cardiac function. Low levels of serum triiodothyronine (T3) due to nonthyroidal illness syndrome may have adverse effects in heart failure (HF). This study was designed to assess the ability of T3to predict in-hospital outcomes in patients with acute HF. In total, 137 patients without thyroid disease or treatment with drugs which affect TH levels, who were hospitalized with acute HF were prospectively enrolled and studied. TH levels were tested upon hospital admission, and outcomes were compared between patients with low (<2.3 pg/ml) and normal (≥2.3 pg/ml) free T3levels as well as between those with low (<0.6 ng/ml) and normal (≥0.6 ng/ml) total T3levels. Low free T3correlated with an increased length of stay in the hospital (median 11 vs 7 days, p <0.001) and higher rates of intensive care unit admission (31.8% vs 16.9%, p = 0.047), with a trend toward increased need for invasive mechanical ventilation (9.0% vs 1.4%, p = 0.056). Low total T3 correlated with an increased length of stay in the hospital (median 11 vs 7 days, p <0.001) and increased need for invasive mechanical ventilation (9.8% vs 1.3%, p = 0.045). In conclusion, low T3predicts worse hospital outcomes in patients with acute HF and can be useful in the risk stratification of these patients.
authors.affiliation: Division of Endocrinology, Winthrop-University Hospital, Mineola, New York. Electronic address: grothberger@winthrop.org.
authors.forename: Gary D
authors.initials: GD
authors.lastname: Rothberger
authors.affiliation: Division of Cardiology, Winthrop-University Hospital, Mineola, New York.
authors.forename: Sonya
authors.initials: S
authors.lastname: Gadhvi
authors.affiliation: Division of Cardiology, Winthrop-University Hospital, Mineola, New York.
authors.forename: Nickolaos
authors.initials: N
authors.lastname: Michelakis
authors.affiliation: Department of Pathology, Winthrop-University Hospital, Mineola, New York.
authors.forename: Amit
authors.initials: A
authors.lastname: Kumar
authors.affiliation: Department of Biostatistics, Winthrop-University Hospital, Mineola, New York.
authors.forename: Rose
authors.initials: R
authors.lastname: Calixte
authors.affiliation: Division of Endocrinology, Winthrop-University Hospital, Mineola, New York.
authors.forename: Lawrence E
authors.initials: LE
authors.lastname: Shapiro
mesh_terms: D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005067:Euthyroid Sick Syndromes / Q000097:blood*; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000628:therapy; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D007902:Length of Stay / Q000706:statistics & numerical data*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012121:Respiration, Artificial / Q000706:statistics & numerical data*; D014284:Triiodothyronine / Q000097:blood*
chemical_list: D014284:Triiodothyronine