AUTHOR=Wang Chuanhe , Han Su , Li Ying , Tong Fei , Li Zhichao , Sun Zhijun 

TITLE=Value of FT3/FT4 Ratio in Prognosis of Patients With Heart Failure: A Propensity-Matched Study

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.859608

DOI=10.3389/fcvm.2022.859608

ISSN=2297-055X

ABSTRACT=Aims: Abnormal thyroid hormone secretions can alter the manifestation and prognosis of cardiovascular disease (CVD). To assess the effect of the free triiodothyronine (FT3)/free thyroxine (FT4) ratio on the prognosis of patients with heart failure (HF), we performed a propensity-matched study on patients with well-balanced baseline characteristics.
Methods: Overall, 8887 patients with HF were divided into two groups according to the FT3/FT4 ratio. Propensity scores were calculated from each patient. A cohort comprising 2164 pairs with high or low ratios and with 34 well-balanced baseline characteristics was then assembled. The endpoints were CVD and all-cause mortality. The correlation between FT3/FT4 ratio and prognosis was assessed using matched Cox regression analyses. The mean follow-up was 3.3 years.
Results: In the full pre-match cohort, 3710 (41.7%) patients died, with 2581 (29.0%) cases of CVD mortality. In the matched-pair cohort, all-cause mortality occurred in 923 (1238/10,000 person-years of follow-up) patients with a high ratio and 1036 (1484/10,000 person-years) patients with a low ratio, resulting in a matched HR of 0.841 (95% CI: 0.769-0.919; P＜0.001). For CVD mortality, the result was 638 (856/10,000 person-years) and 714 (1023/10,000 person-years) patients, respectively, resulting in a matched HR of 0.844 (95% CI: 0.759-0.940; P＜0.001). Subgroup analysis revealed that a low FT3/FT4 ratio had a greater predictive value for all-cause and CVD mortality in elderly or male patients and in patients with CVD, hypertension, diabetes mellitus, HFmrEF, or HFpEF.
Conclusions: A low FT3/FT4 ratio is valuable for predicting CVD and all-cause mortality in patients with HF.