ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Cardiovascular Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1543378
Predicting Major Cardiac and Cerebrovascular Events in Acute Coronary Syndrome Patients Using the Thyroid Hormone Sensitivity Index
Provisionally accepted
Hui He1Long Xia2Tao Ye2
Su Hong2
Yan Luo2Qiang Chen2Qiao Feng1Xiufen Peng1Maoling Jiang1
Hanxiong Liu2
Tao Xiang2*
Shiqiang Xiong2*
Cai Lin1,2*- 1Southwest Medical University, Luzhou, Sichuan, China
- 2Chengdu Third People's Hospital, Chengdu, China
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The thyroid hormone sensitivity index provides a new perspective for investigating nuanced alterations in thyroid function in cardiovascular disorders. However, the predictive value of thyroid hormone sensitivity indices for adverse events following percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS) patients remains unknown. This study aimed to investigate the predictive value of thyroid sensitivity indices for major adverse cardiac and cerebrovascular events (MACCEs) in these patients.A total of 431 patients were included in the analysis. Thyroid hormone sensitivity indices were calculated using the thyroid-stimulating hormone index (TSHI), thyrotrophic thyroxine resistance index (TT4RI), thyroid feedback quantile-based index (TFQI), and parametric thyroid feedback quantile-based index (PTFQI). During the median follow-up period, 50 (11.60%) patients experienced MACCEs. Multivariate Cox regression analysis revealed that TSHI (HR 1.277, 95% CI 1.110-1.468, P<0.001), TT4RI (HR 1.002, 95% CI 1.001-1.003, P<0.001), TFQI (HR 1.130, 95% CI 1.043-1.224, P=0.003), and PTFQI (HR 1.237, 95% CI 1.107-1.383, P<0.001) were independent predictors of MACCEs. The area under the ROC curve (AUROC) revealed that PTFQI had the highest predictive value (AUROC =0.688, 95% CI: 0.595-0.780; P < 0.001). Adding PTFQI to the GRACE score can enhance the risk prediction of MACCEs in ACS patients undergoing PCI, AUROC = 0.759 (95% CI 0.676-0.842, P < 0.001) vs AUROC = 0.646 (95% CI 0.563-0.729, P = 0.001), and there is a significant difference (P = 0.0108). Subgroup analysis indicated that PTFQI had a more significant predictive value for MACCEs in males and patients with abnormal blood glucose.Thyroid hormone sensitivity indices are associated with a greater risk of MACCEs in patients with ACS following PCI.
Keywords: Acute Coronary Syndrome, Percutaneous Coronary Intervention, Thyroid hormone sensitivity, Major adverse cardiac and cerebrovascular events, progonisis
Received: 11 Dec 2024; Accepted: 10 Jun 2025.
Copyright: © 2025 He, Xia, Ye, Hong, Luo, Chen, Feng, Peng, Jiang, Liu, Xiang, Xiong and Lin. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Tao Xiang, Chengdu Third People's Hospital, Chengdu, China
Shiqiang Xiong, Chengdu Third People's Hospital, Chengdu, China
Cai Lin, Chengdu Third People's Hospital, Chengdu, China
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