Abstract
BACKGROUND: Thyroid dysfunction might have a negative impact on the prognosis of patients with heart failure (HF) and affect the lipid metabolism. The aim of our study was to investigate the prognostic role of thyroid dysfunction and its relationship with lipid profile in hospitalized HF patients. HYPOTHESIS: Thyroid dysfunction strongly correlates with prognosis of HF patients and combination with lipid profile improves the prognostic value. METHODS: We performed a single-center retrospective cohort study including hospitalized HF patients between March 2009 and June 2018. RESULTS: Among enrolled 3733 patients, low fT3 (hazard ratio [HR] 1.33; 95% CI: 1.15-1.54; p < .001), elevated TSH (HR 1.37; 95% CI 1.15-1.64; p < .001), LT3S (HR 1.39; 95% CI: 1.15-1.68; p < .001), overt hyperthyroidism (HR 1.73; 95%CI: 1.00-2.98; p = .048), subclinical hypothyroidism (HR 1.43; 95%CI: 1.13-1.82; p = .003) and overt hypothyroidism (HR 1.76; 95%CI: 1.33-2.34; p < .001) independently increased the risk of composite endpoint defined as the combination of all-cause mortality, heart transplantation, or left ventricular assist device requirement. Higher total cholesterol (HR 0.64; 95%CI: 0.49-0.83; p < .001) was still a protective factor in HF patients. When divided into four groups by fT3 and median lipid profiles, comparison of Kaplan-Meier survival curves for various groups showed good risk stratification (p < .001). CONCLUSION: LT3S, overt hyperthyroidism, subclinical and overt hypothyroidism were independently associated with poor outcomes in HF. The combination of fT3 and lipid profile improved the prognostic value.