Author(s): Li X, Yang X, Wang Y, Ding L, Wang J, , Li X, Yang X, Wang Y, Ding L, Wang J,
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Abstract BACKGROUND: Subclinical thyroid dysfunction may be a risk factor for mortality in patients with heart failure and may be associated with dilated cardiomyopathy (DCM). This was a cohort study to examine the possible association between subclinical thyroid dysfunction and all-cause mortality in DCM patients, because the current evidence on this association remains elusive. METHODS AND RESULTS: A total of 963 DCM patients were evaluated for thyroid function. Of these patients, 7.1\% (n = 68) had subclinical hyperthyroidism (defined as serum thyroid-stimulating hormone [TSH] <0.35 μIU/mL), 84.7\% (n = 816) had euthyroidism (TSH 0.35-5.5 μIU/mL), and 8.2\% (n = 79) had subclinical hypothyroidism (TSH >5.5 μIU/mL). There was a significant difference in all-cause mortality rates between patients with euthyroidism and patients with subclinical hyper- and hypothyroidism (21\%, 38.2\%, and 26.6\%, respectively; log-rank χ(2) = 13.104; P = .001) with mean follow-up of 3.5 years. After adjustment for other confounding factors at baseline, QRS duration, N-terminal pro-B-type natriuretic peptide, New York Heart Association functional class, left atrial diameter, and subclinical hyperthyroidism (hazard ratio 1.793, 95\% CI 1.010-3.183; P = .046) emerged as significant predictors of all-cause mortality. CONCLUSION: DCM patients with subclinical hyper- and hypothyroidism had higher all-cause mortality rates. However, only subclinical hyperthyroidism, not subclinical hypothyroidism, was an independent predictor for increased risk of all-cause mortality. Copyright © 2014 Elsevier Inc. All rights reserved.
This article was published in J Card Fail
and referenced in Journal of Thyroid Disorders & Therapy