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Prognostic implications of thyroid hormones in acute aortic dissection: mediating roles of renal function and coagulation.
Shen, Xuejun; Wu, Shiwan; Yan, Jingyi; Yan, Hongle; Zhou, Shuyi; Weng, Huozhen; Yang, Shengli; Li, Weiping.
Afiliación
  • Shen X; Department of Cardiology, First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China.
  • Wu S; Clinical Research Center, First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China.
  • Yan J; Shantou University Medical College, Shantou, Guangdong, China.
  • Yan H; Department of Cardiology, First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China.
  • Zhou S; Clinical Research Center, First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China.
  • Weng H; Department of Cardiology, First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China.
  • Yang S; Clinical Research Center, First Affiliated Hospital of Shantou University Medical College, Shantou, Guangdong, China.
  • Li W; Shantou University Medical College, Shantou, Guangdong, China.
Front Endocrinol (Lausanne) ; 15: 1387845, 2024.
Article en En | MEDLINE | ID: mdl-39157680
ABSTRACT

Background:

Thyroid hormones significantly influence cardiovascular pathophysiology, yet their prognostic role in acute aortic dissection (AAD) remains inadequately explored. This study assesses the prognostic value of thyroid hormone levels in AAD, focusing on the mediating roles of renal function and coagulation.

Methods:

We included 964 AAD patients in this retrospective cohort study. Utilizing logistic regression, restricted cubic splines, and causal mediation analysis, we investigated the association between thyroid hormones and in-hospital mortality and major adverse cardiovascular events (MACEs).

Results:

In AAD patients overall, an increase of one standard deviation in FT4 levels was associated with a 31.9% increased risk of MACEs (OR 1.319; 95% CI 1.098-1.584) and a 36.1% increase in in-hospital mortality (OR 1.361; 95% CI 1.095-1.690). Conversely, a higher FT3/FT4 ratio was correlated with a 20.2% reduction in risk of MACEs (OR 0.798; 95% CI 0.637-0.999). This correlation was statistically significant predominantly in Type A AAD, while it did not hold statistical significance in Type B AAD. Key renal and coagulation biomarkers, including blood urea nitrogen, creatinine, cystatin C, prothrombin time ratio, prothrombin time, and prothrombin time international normalized ratio, were identified as significant mediators in the interplay between thyroid hormones and MACEs. The FT3/FT4 ratio exerted its prognostic influence primarily through the mediation of renal functions and coagulation, while FT4 levels predominantly impacted outcomes via a partial mediation effect on coagulation.

Conclusion:

FT4 levels and the FT3/FT4 ratio are crucial prognostic biomarkers in AAD patients. Renal function and coagulation mediate the association between the thyroid hormones and MACEs.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hormonas Tiroideas / Coagulación Sanguínea / Disección Aórtica Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Front Endocrinol (Lausanne) Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hormonas Tiroideas / Coagulación Sanguínea / Disección Aórtica Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Front Endocrinol (Lausanne) Año: 2024 Tipo del documento: Article País de afiliación: China Pais de publicación: Suiza