The model of adverse course of heart failure with account of the thyroid status of patients
Journal Title: Український терапевтичний журнал - Year 2019, Vol 0, Issue 3
Abstract
Objective — to determine the predictors of adverse course of heart failure (HF) with account of the thyroid status of patients. Materials and methods. The study involved 157 patients with HF (and previous myocardial infarction). On admission, the standard physical examinations were carried out, the parameters of intracardiac hemodynamics, clinical and biochemical blood tests, and levels of thyroid hormones were evaluated. Results and discussion. It has been established that the risk of rehospitalization due to decompensation of the HF increased when the optimal cut-off serum level for the free triiodothyronine (T3f) ≤ 2.07 pmol/l was exceeded (sensitivity 67.77 % and specificity 71.05 %, p = 0.0017). The relative risk of rehospitalization of patients with HF during 2 years, with a level of T3f ≤ 2.07 pmol/l, is 2.224 [1.363—3.630] (p < 0.05). By means of automatic regression analysis, a model of the rehospitalization of patients with HF due to decompensation of the disease within 2 years was built. It included: body mass (a = 0.009, p = 0.0001), T3f level (a = –0.122, p = 0.0001), presence of nontoxic goiter (a = 0.340, p = 0.001), LDL cholesterol (a = 0.116, p = 0.002) and total cholesterol (a = –0.072, p = 0.002) levels, the relative content of granulocytes in blood (a = –0.007, p = 0.017), free thyroxine T4f levels (a = 0.013, p = 0.026). According to ROC-analysis, the risk of rehospitalization of patients increased when the optimal cut-off point for the regression model equation exceeded ≥ 1,321 conventional units (sensitivity 93.78 % and specificity 40.45 %, p = 0.0001). Conclusions. Taking into account the obtained data on the effect of the decreased serum T3 levels on the HF course, it can be assumed that its value ≤ 2.07 pmol/l can be used as a predictor for an unfavourable disease course. The regression model of the rehospitalization of patients with HF includes: body mass, concentrations of thyroxin and triiodthyronin, the presence of nontoxic goiter, height, levels of total and LDL cholesterol, relative granulocytes’ level in blood. The risk of rehospitalization of patients with HF due to the disease decompensation increases, when the regression equation of the model ≥ 1.321 conventional units is exceeded.
Authors and Affiliations
S. M. Pyvovar
Keywords
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- EP ID EP666920
- DOI 10.30978/UTJ2019-3-22
- Views 77
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