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Thyroid-Stimulating...
Thyroid-Stimulating Hormone and Clinical Outcomes: The CORONA Trial (Controlled Rosuvastatin Multinational Study in Heart Failure)
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Perez, A. C. (author)
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Jhund, P. S. (author)
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Stott, D. J. (author)
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Gullestad, L. (author)
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Cleland, J. G. F. (author)
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van Veldhuisen, D. J. (author)
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- Wikstrand, John, 1938 (author)
- Gothenburg University,Göteborgs universitet,Wallenberglaboratoriet,Wallenberg Laboratory
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Kjekshus, J. (author)
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McMurray, J. J. V. (author)
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(creator_code:org_t)
- Elsevier BV, 2014
- 2014
- English.
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In: JACC: Heart Failure. - : Elsevier BV. - 2213-1779. ; 2:1, s. 35-40
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Abstract
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- Objectives: This study sought to examine the association between thyroid status and clinical outcomes in patients in the CORONA (Controlled Rosuvastatin Multinational Trial in Heart Failure) study. Background: Hypo- and hyperthyroidism were associated with worse clinical outcomes in the SCD-HeFT (Sudden Cardiac DeathinHeart Failure Trial). Methods: In CORONA, 4,987 patients underwent baseline thyroid-stimulating hormone (TSH) measurement, 237 of which(4.8%) were receiving thyroid replacement therapy (TRT). Patients were classified as euthyroid (TSH: 0.3 to 5.0μU/ml,and no TRT), hyperthyroid (<0.3 μU/ml and no TRT), or hypothyroid (>5.0 μU/ml and no TRT). The outcome composites of cardiovascular (CV) death or hospitalization for heart failure (HF), the components of this composite, and all-cause death were compared among hyperthyroid, hypothyroid, and euthyroid states, using multivariable models adjusting for previously reported prognostic variables. Results: A total of 91.3% of patients were euthyroid, 5.0% were hypothyroid, and 3.7% were hyperthyroid. Compared with euthyroid patients, hypothyroid patients were more likely to have a history of stroke, had worse renal function andhigher N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels, were more likely to be treated with an antiarrhythmic drug (or have an implantable cardioverter defibrillator), and were less likely to smoke or be treated with a beta-blocker or angiotensin-converting enzyme inhibitor/angiotensin receptor blocker. In univariate analyses, hypothyroidism was associated with an increased risk of the composite outcome of CV death or HF hospitalization (hazard ratio: 1.29; 95% confidence interval: 1.07 to 1.57; p= 0.008), as well as all-cause death (HR: 1.36; 95% confidence interval: 1.03 to 1.76; p= 0.004). However, after adjustment for other known predictors of outcome, the associations were weakened, and when NT-proBNP was added to the models, the association between hypothyroidism and all outcomes was eliminated. Conclusions: Thyroid status is not an independent predictor of outcome in heart failure with reduced ejection fraction. (Controlled Rosuvastatin Multinational Study in Heart Failure [CORONA]; NCT00206310). © 2014 American College of Cardiology Foundation.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Clinical outcome
- Hyperthyroidism
- Hypothyroidism
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Perez, A. C.
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Jhund, P. S.
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Stott, D. J.
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Gullestad, L.
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Cleland, J. G. F ...
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van Veldhuisen, ...
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show more...
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Wikstrand, John, ...
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Kjekshus, J.
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McMurray, J. J. ...
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show less...
- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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JACC: Heart Fail ...
- By the university
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University of Gothenburg