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IF 6.7 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiac Failure Pub Date : 2024-12-11 DOI:10.1016/j.cardfail.2024.11.010

Jeppe Kofoed Petersen, Christian Selmer, Søren Lund Kristensen, Rasmus Rørth, Adelina Yafasova, Lucas Grove Bager Vejlstrup, Sam Aiyad Ali, Morten Schou, Lars Køber, Emil Loldrup Fosbøl, Lauge Østergaard

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引用次数: 0

摘要

背景：有关甲状腺功能障碍对心力衰竭（HF）患者预后影响的数据很少。我们的目的是在一个全国性的心力衰竭患者队列中研究这两种疾病之间的关联：这项丹麦队列研究评估了 2000-2021 年间首次被诊断为心力衰竭的患者的甲状腺功能。根据确诊心房颤动前一年内记录的实验室甲状腺功能值（甲状腺功能正常、明显/亚临床甲状腺功能减退或甲状腺功能亢进）对患者进行分类。主要结果是死亡率和心房颤动住院率的综合，采用累积发病率函数进行检验。在对主要合并症进行调整后，进行了 Cox 比例危险分析，以研究各组间结果的差异：本研究共纳入 58067 人（43.9% 为女性，中位年龄为 75.7 岁 [p25-p75:66.4-83.5]），其中 54319 人（93.6%）为甲状腺功能正常，1669 人（2.9%）为亚临床甲状腺功能减退，239 人（0.4%）为明显甲状腺功能减退，1633 人（2.8%）为亚临床甲状腺功能亢进，207 人（0.4%）为明显甲状腺功能亢进。与甲状腺功能正常的患者相比，亚临床甲减患者的综合结果调整后一年HR为1.11（95% CI，1.02-1.20），显性甲减患者的综合结果调整后一年HR为1.24（95% CI，1.02-1.51），亚临床甲亢患者的综合结果调整后一年HR为1.06（95% CI，0.98-1.15），显性甲亢患者的综合结果调整后一年HR为1.27（95% CI，1.00-1.60）。这种正相关性主要是由于死亡率的增加：甲状腺功能减退症和甲状腺功能亢进症患者在确诊心房颤动前一年内同时存在甲状腺功能减退症和甲状腺功能亢进症，与死亡率和心房颤动住院率的综合风险增加有关。我们的研究结果表明，这是一个需要提高临床认识的高危人群。

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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Prognostic impact of thyroid function in patients with incident heart failure: a nationwide study.

Background: There is a paucity of data on the prognostic impact of thyroid dysfunction in patients with heart failure (HF). We aimed to examine the association between these two conditions in a nationwide cohort of patients with HF.

Methods: This Danish cohort study evaluated the thyroid function of patients diagnosed with first-time HF from 2000-2021. Patients were categorized according to laboratory-based thyroid function values (euthyroid, overt/subclinical hypothyroidism, or hyperthyroidism) recorded within one year before the HF diagnosis. The primary outcome was a composite of mortality and hospitalization for HF, examined using the cumulative incidence function. Cox proportional hazard analysis adjusted for major comorbidities was performed to investigate differences in outcomes among groups.

Results: Of the 58,067 individuals included in this study (43.9% female, median age 75.7 years [p25-p75:66.4-83.5]), 54,319 (93.6%) were euthyroid, 1,669 (2.9%) had subclinical hypothyroidism, 239 (0.4%) had overt hypothyroidism, 1,633 (2.8%) had subclinical hyperthyroidism, and 207 (0.4%) had overt hyperthyroidism. Compared with euthyroid patients, the adjusted one-year HR of the composite outcome was 1.11 (95% CI, 1.02-1.20) in patients with subclinical hypothyroidism, 1.24 (95% CI, 1.02-1.51) in patients with overt hypothyroidism, 1.06 (95% CI, 0.98-1.15) in patients with subclinical hyperthyroidism, and 1.27 (95% CI, 1.00-1.60) in patients with overt hyperthyroidism. This positive association was mainly driven by the increased mortality rates.

Conclusion: In patients with incident HF, the presence of both hypo- and hyperthyroidism up to one year prior to HF diagnosis was associated with increased risk of the composite of mortality and hospitalization for HF. Our results demonstrate a high-risk group of patients in need of increased clinical awareness.

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来源期刊

Journal of Cardiac Failure 医学-心血管系统

CiteScore

7.80

自引率

8.30%

发文量

653

审稿时长

21 days

期刊介绍： Journal of Cardiac Failure publishes original, peer-reviewed communications of scientific excellence and review articles on clinical research, basic human studies, animal studies, and bench research with potential clinical applications to heart failure - pathogenesis, etiology, epidemiology, pathophysiological mechanisms, assessment, prevention, and treatment.