Value of the fT3/fT4 ratio and its combination with the GRACE risk score in predicting the prognosis in euthyroid patients with acute myocardial infarction undergoing percutaneous coronary intervention: a prospective cohort study

• Published in: BMC cardiovascular disorders 2018-09, Vol.18 (1), p.181-181, Article 181
• Main Authors: Yu, Tongtong, Tian, Chunyang, Song, Jia, He, Dongxu, Wu, Jiake, Wen, Zongyu, Sun, Zhijun, Sun, Zhaoqing
• Format: Article
• Language: English
• Subjects: Acute myocardial infarction; Aged; Angioplasty; Biomarkers - blood; Cardiovascular disease; Cardiovascular system; Care and treatment; Cohort analysis; Decision Support Techniques; Electrocardiography; Female; fT3/fT4 ratio; GRACE risk score; Health risk assessment; Heart attack; Humans; Male; Middle Aged; Mortality; Multivariate analysis; Myocardial infarction; Myocardial Infarction - blood; Myocardial Infarction - diagnosis; Myocardial Infarction - mortality; Myocardial Infarction - surgery; Percutaneous coronary intervention; Percutaneous Coronary Intervention - adverse effects; Percutaneous Coronary Intervention - mortality; Predictive Value of Tests; Prognosis; Prospective Studies; Risk Assessment; Risk Factors; Thyroid Function Tests; Thyroid hormones; Thyroxine - blood; Time Factors; Treatment Outcome; Triiodothyronine - blood
• ISSN: 1471-2261; 1471-2261
• DOI: 10.1186/s12872-018-0916-z

Thyroid hormones deeply influence the cardiovascular system; however, the association between the fT3/fT4 ratio and the clinical outcome in euthyroid patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) is not well defined. Therefore, the present study aimed to assess the prognostic performance of the fT3/fT4 ratio in predicting the long-term prognosis in euthyroid patients with AMI undergoing PCI. In a prospective cohort study with a 1-year follow-up, according to the clinical end point, 953 euthyroid individuals (61.0 ± 11.6; female, 25.8%) were divided into two groups: (1) the survival group (n = 915) and (2) the death group (n = 38). According to Cox regression multivariate analysis, fT4 (HR: 1.249, 95% CI: 1.053-1.480, p = 0.010) and the fT3/fT4 ratio (HR: 3.546, 95% CI: 1.705-7.377, p = 0.001) were associated with an increased risk of 1-year all-cause mortality. The prognostic performance of the fT3/fT4 ratio was similar to the Global Registry of Acute Coronary Events (GRACE) score in predicting 1-year all-cause mortality (C-statistic: z = 0.261, p = 0.794; IDI: -0.017, p = 0.452; NRI: -0.049, p = 0.766), but better than fT4 (C-statistic: z = 2.438, p = 0.015; IDI: 0.053, p = 0.002; NRI: 0.656, p