Non-thyroidal illness syndrome in patients with cardiovascular diseases: A systematic review and meta-analysis

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• 作者：Bin Wang^a ; Suijun Liu^b ; Ling Li^a ; Qiuming Yao^a ; Ronghua Song^a ; Xiaoqing Shao^a ; Qian Li^a ; Xiaohong Shi^a ; Jin-an Zhang^a ; ^{zhangjinan@hotmail.com}
• 关键词：Non-thyroidal illness syndrome ; Cardiovascular disease ; Meta-analysis
• 刊名：International Journal of Cardiology
• 出版年：2017
• 出版时间：1 January 2017
• 年：2017
• 卷：226
• 期：Complete
• 页码：1-10
• 全文大小：717 K
• 卷排序：226

文摘

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.MethodsWe 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.ResultsForty-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).ConclusionNTIS 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.