Relation Between Thyroid Function and Mortality in Patients With Chronic Heart Failure

•Subclinical thyroid dysfunction is very common in patients with chronic heart failure (?10%). •There a U-shaped relation between Thyroid-Stimulating Hormone and mortality. hypothyroidism associated worse outcome univariable analysis, but the association disappears after adjustment for age natriuretic peptide level. weak significant increasing normal ejection fraction. Thyroid (CHF), there conflicting evidence regarding its prognostic significance. We investigated function prognosis large, well characterized cohort of ambulatory CHF. Heart was defined as signs symptoms disease either left ventricular systolic (LVSD) mild or (heart reduced fraction [HFrEF]), no LVSD raised amino-terminal pro-B-type (NT-proBNP) levels (>125 ng/L; [HFnEF]). Euthyroid state thyroid-stimulating hormone (TSH) level 0.35 4.70 mIU/l, TSH >4.70 hyperthyroidism <0.35 mIU/l. 2997 had HFrEF 1995 HFnEF. 4491 (90%) were euthyroid, 312 (6%) hypothyroid, 189 (4%) hyperthyroid. In both hypothyroid (hazard ratio [HR] 1.25, 95% confidence interval [CI] 1.08 to 1.45) hyperthyroid (HR 1.21, CI 1.01 1.46) greater risk death compared euthyroid patients. There outcome. Increasing predictor mortality analysis 1.02, 1.03), disappeared multivariable analysis. The three strongest predictors adverse age, NT-proBNP, higher NYHA class. conclusion, although survival CHF, it not an independent