FT3/FT4 Enhances Risk Assessment in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention Based on GRACE 2.0 Score.

IF 2.6 3区医学 Q2 PERIPHERAL VASCULAR DISEASE

Angiology Pub Date : 2025-02-01 Epub Date: 2023-10-24 DOI:10.1177/00033197231199228

Chuyi Han, Le Wang, Chunwei Liu, Wei Qi, Rui Zhang, Ao Wei, Hua Yang, Chen Wang, Yuecheng Hu, Jinghan Xu, Yingyi Zhang, Wenyu Li, Tingting Li, Dongxia Jin, Hongliang Cong, Jingxia Zhang

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Abstract

Little is known about the association between the free triiodothyronine/free thyroxine (FT3/FT4) ratio and clinical outcomes in euthyroid patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) undergoing percutaneous coronary intervention (PCI). A total of 1448 euthyroid patients with NSTE-ACS who underwent PCI were included in this prospective study. Multivariate Cox regression analysis revealed that there was a significantly increased risk of stroke (hazard ratio [HR] 11.380, 95% confidence interval [CI]: 1.386-93.410, P = .024) and major adverse cardiovascular and cerebrovascular events (MACCEs) (HR 3.364, 95% CI: 1.595-7.098, P = .001) in patients in lower FT3/FT4 tertiles. The combined model of FT3/FT4 ratio and the Global Registry of Acute Coronary Events (GRACE) score provided the added value of risk assessment by improving C-statistics, integrated discrimination improvement (IDI), and the net reclassification index (NRI) (all P < .05). Thus, in euthyroid patients with NSTE-ACS undergoing PCI, the FT3/FT4 ratio was not only an independent prognostic indicator of long-term MACCE but also enhanced risk discrimination when combined with the GRACE risk score, which suggests that the calculation of FT3/FT4 before and after PCI may contribute to risk stratification in this particular patient group.

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基于GRACE 2.0评分FT3/FT4增强经皮冠状动脉介入治疗非st段抬高急性冠状动脉综合征患者的风险评估

在接受经皮冠状动脉介入治疗（PCI）的非ST段抬高型急性冠状动脉综合征（NSTE-ACS）甲状腺功能正常患者中，游离三碘甲状腺原氨酸/游离甲状腺素（FT3/FT4）比率与临床结果之间的关系知之甚少。本前瞻性研究共纳入1448例接受PCI治疗的非ST段抬高型急性冠脉综合征甲状腺功能正常患者。多变量Cox回归分析显示，FT3/FT4三分位数较低的患者发生中风（危险比[HR]13.80，95%可信区间[CI]1.386-93.410，P=0.024）和主要心脑血管不良事件（MACCE）（HR3.364，95%CI:1.595-7.098，P=0.001）的风险显著增加。FT3/FT4比值和急性冠状动脉事件全球登记（GRACE）评分的联合模型通过改进C统计量、综合判别改善（IDI）和净再分类指数（NRI）提供了风险评估的附加值（均为P。05）。因此，在接受PCI的NSTE-ACS甲状腺功能正常患者中，FT3/FT4比率不仅是长期MACCE的独立预后指标，而且与GRACE风险评分相结合时，还能增强风险辨别能力，这表明PCI前后FT3/FT4-的计算可能有助于该特定患者组的风险分层。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Angiology 医学-外周血管病

CiteScore

5.50

自引率

14.30%

发文量

180

审稿时长

6-12 weeks

期刊介绍： A presentation of original, peer-reviewed original articles, review and case reports relative to all phases of all vascular diseases, Angiology (ANG) offers more than a typical cardiology journal. With approximately 1000 pages per year covering diagnostic methods, therapeutic approaches, and clinical and laboratory research, ANG is among the most informative publications in the field of peripheral vascular and cardiovascular diseases. This journal is a member of the Committee on Publication Ethics (COPE). Average time from submission to first decision: 13 days