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Thyroid dysfunction only weakly predictive of survival in chronic heart failure

10 Jan 2021

While thyroid dysfunction does worsen survival among patients with chronic heart failure (CHF), there are other stronger predictive factors of adverse outcomes in these patients, a new study has shown.

Researchers retrospectively assessed 4,492 heart failure patients, in whom thyroid function was evaluated according to levels of the thyroid-stimulating hormone (TSH) and free thyroxine. The primary outcome of interest was all-cause mortality, while a secondary outcome was the composite between mortality or hospitalization with heart failure.

Over a median follow-up duration of 4.6 years, a total of 2,879 participants died, yielding a mortality rate of 58 percent. Unadjusted analyses found that participants with either hypo- or hyperthyroidism were at greater risk of all-cause mortality.

When excluding the lowest quintile of TSH from the analysis, increasing levels of TSH correlated with an increasing risk of death. However, when the highest quintile of TSH was removed from the analysis, no clear interaction was observed. Kaplan-Meier confirmed that hyper- and hypothyroid CHF patients had impaired survival than their euthyroid comparators.

However, multivariable adjustments for confounders attenuated the effect of all three thyroid dysfunction measures (hyperthyroidism, hypothyroidism, and increasing TSH concentrations) on survival.

Instead, age, a higher New York Heart Association class, and increasing levels of the N-terminal pro-B-type natriuretic peptide were found to be the strongest independent predictors of mortality. The same three factors were significantly predictive of the secondary outcome, while thyroid dysfunction was not.

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Most Read Articles
01 Dec 2020
Tetanus toxoid 5 Lf, diphtheria toxoid 2 Lf, pertussis toxoid 2.5 mcg, filamentous haemagglutinin 5 mcg, fimbriae types 2 and 3 5 mcg, pertactin 3 mcg
Dr. Hsu Li Yang, Dr. Tan Thuan Tong, Dr. Andrea Kwa, 08 Jan 2021
Antimicrobial resistance has become increasingly dire as the rapid emergence of drug resistance, especially gram-negative pathogens, has outpaced the development of new antibiotics. At a recent virtual symposium, Dr Hsu Li Yang, Vice Dean (Global Health) and Programme Leader (Infectious Diseases), NUS Saw Swee Hock School of Public Health, presented epidemiological data on multidrug-resistant (MDR) gram-negative bacteria (GNB) in Asia, while Dr Tan Thuan Tong, Head and Senior Consultant, Department of Infectious Diseases, Singapore General Hospital (SGH), focused on the role of ceftazidime-avibactam in MDR GNB infections. Dr Andrea Kwa, Assistant Director of Research, Department of Pharmacy, SGH, joined the panel in an interactive fireside chat, to discuss challenges, practical considerations, and solutions in MDR gram-negative infections. This Pfizer-sponsored symposium was chaired by Dr Ng Shin Yi, Head and Senior Consultant of Surgical Intensive Care, SGH.
Pearl Toh, 26 Nov 2020
Inhaled corticosteroid (ICS) should be the mainstay of long-term asthma management — such is the key message of the latest Singapore ACE* Clinical Guidance (ACG) for asthma, released in October 2020.
2 days ago
Among patients with moderate-to-severe psoriasis, the use of biologics appears to lower the risk of being hospitalized for the novel coronavirus disease (COVID-19), a new study has found.