Bin Wang1, Suijun Liu2, Ling Li1, Qiuming Yao1, Ronghua Song1, Xiaoqing Shao1, Qian Li1, Xiaohong Shi1, Jin-An Zhang3. 1. Department of Endocrinology, Jinshan Hospital of Fudan University, Shanghai 201508, China. 2. Department of Nephrology, Xi'an Central Hospital, Xi'an 710003, China. 3. Department of Endocrinology, Jinshan Hospital of Fudan University, Shanghai 201508, China. Electronic address: zhangjinan@hotmail.com.
Abstract
BACKGROUND: Non-thyroidal illness syndrome (NTIS) is characterized by decreased serum triiodothyronine level without increased thyroid-stimulating hormone level during critical illness. The summary data on the prevalence of NTIS in cardiovascular patients are lacking, and its prognostic role in cardiovascular patients is also unclear. METHODS: We performed a systematic review and meta-analysis to comprehensively determine the prevalence and the prognostic role of NTIS in cardiovascular patients. The prevalence of NTIS was pooled using random-effect meta-analysis and the hazard ratios (HRs) for all-cause mortality, cardiac mortality and major adverse cardiovascular events (MACE) were also pooled. RESULTS: Forty-one studies were finally included. The pooled prevalence of NTIS in cardiovascular patients was 21.7% (95% CI 18.4%-25.3%). Subgroup by the types of cardiovascular diseases showed the prevalence of NTIS was highest in patients with heart failure (24.5%), followed by acute myocardial infarction (18.9%) and acute coronary syndrome (17.1%). Meta-analysis of studies using strict diagnostic criteria of NITS showed that the pooled prevalence of NTIS in cardiovascular patients was 17.6% (95% CI 14.5%-21.2%). NTIS was independently associated with increased risks of all-cause mortality (HR=2.52, 95% CI 1.87-3.40, P<0.001) and cardiac mortality (HR=2.06, 95% CI 1.58-2.69, P<0.001) in cardiovascular patients. NTIS was also an independent predictor of MACE in cardiovascular patients (HR=1.73, 95% CI 1.32-2.26, P<0.001). CONCLUSION: NTIS is very common in patients with cardiovascular diseases. NTIS is an independent prognostic factor in cardiovascular patients and is associated with increased risks of all-cause mortality, cardiac mortality and MACE. Copyright Â
BACKGROUND:Non-thyroidal illness syndrome (NTIS) is characterized by decreased serum triiodothyronine level without increased thyroid-stimulating hormone level during critical illness. The summary data on the prevalence of NTIS in cardiovascularpatients are lacking, and its prognostic role in cardiovascularpatients is also unclear. METHODS: We performed a systematic review and meta-analysis to comprehensively determine the prevalence and the prognostic role of NTIS in cardiovascularpatients. The prevalence of NTIS was pooled using random-effect meta-analysis and the hazard ratios (HRs) for all-cause mortality, cardiac mortality and major adverse cardiovascular events (MACE) were also pooled. RESULTS: Forty-one studies were finally included. The pooled prevalence of NTIS in cardiovascularpatients was 21.7% (95% CI 18.4%-25.3%). Subgroup by the types of cardiovascular diseases showed the prevalence of NTIS was highest in patients with heart failure (24.5%), followed by acute myocardial infarction (18.9%) and acute coronary syndrome (17.1%). Meta-analysis of studies using strict diagnostic criteria of NITS showed that the pooled prevalence of NTIS in cardiovascularpatients was 17.6% (95% CI 14.5%-21.2%). NTIS was independently associated with increased risks of all-cause mortality (HR=2.52, 95% CI 1.87-3.40, P<0.001) and cardiac mortality (HR=2.06, 95% CI 1.58-2.69, P<0.001) in cardiovascularpatients. NTIS was also an independent predictor of MACE in cardiovascularpatients (HR=1.73, 95% CI 1.32-2.26, P<0.001). CONCLUSION: NTIS is very common in patients with cardiovascular diseases. NTIS is an independent prognostic factor in cardiovascularpatients and is associated with increased risks of all-cause mortality, cardiac mortality and MACE. Copyright Â
Authors: Joaquin Lado-Abeal; Carmen Diaz; Gilbert Berdine; Kenneth Iwuji; David Araujo-Vilar; Natalia Lampon-Fernandez; Min Wang; Santiago Lojo; Alfonso Rodriguez-Perez; Ana Marcella Rivas Journal: Endocrine Date: 2020-04-28 Impact factor: 3.633
Authors: Apostolos Chatzitomaris; Rudolf Hoermann; John E Midgley; Steffen Hering; Aline Urban; Barbara Dietrich; Assjana Abood; Harald H Klein; Johannes W Dietrich Journal: Front Endocrinol (Lausanne) Date: 2017-07-20 Impact factor: 5.555