Predictive Value Of Free Triiodothyronine And Left Ventricular Ejection Fraction For Long-term Heart Failure In AMI Patients

Objectives:To investigate whether free triiodothyronine(FT3)and left ventricular ejection(LVEF)are prognosis factors in long-term heart failure(HF)after acute myocardial infarction(AMI).Methods:A total of 565 patients with AMI were enrolled in our hospital from January 2017 to December 2020.According to occurrence of long-term HF after AMI,the patients were divided into HF group and non-HF group.The correlation between FT3 and LVEF was analyzed.The independent predictors of long-term HF were determined by COX regression model.The value of FT3 combined with LVEF in predicting long-term HF in patients with AMI was evaluated by ROC curve.The patients were then divided into three groups by the cut-off values for FT3 and LVEF,and the Kaplan-Meier survival curve was used to analyze the cumulative hazard of HF in all groups.Results:1.After a median follow-up period of 34 months,a total of 146 patients developed HF,and the cumulative incidence of HF was 25.8%,of which the cumulative incidence of HF in patients with LT3S was 64.2%.2.Compared with non-HF group,patients in HF group had lower FT3,LVEF(P all<0.001).3.FT3 levels positively correlated with LVEF,albumin,hemoglobin,and triglycerides(P all<0.05),while negatively correlated with hsCRP,cTnI and age(P all<0.05).4.Multivariable Cox regression analysis suggested that age(HR=1.096,95%CI:1.074-1.119,P<0.001)、hsCRP(HR=1.007,95%CI:1.002-1.011,P=0.002)、FT3(HR=0.700,95%CI:0.518-0.946,P=0.020)and LVEF(HR=0.956,95%CI:0.939-0.973,P<0.001)were independent prognosis factors for long-term HF after AMI.5.The ROC analysis revealed that area under the combination of FT3 and LVEF curve was 0.770(95%CI:0.726-0.814,P<0.001).6.Kaplan-Meier analysis showed that the incidence of long-term HF was highest in the patients with low level of FT3 and LVEF(log-rank P<0.01).Conclusions:1.Compared with AMI patients without HF,FT3 and LVEF were significantly lower in patients with long-term HF.2.FT3 levels may be related to inflammatory status,myocardial infarction size,and nutritional status.3.Lower level of FT3、LVEF、aging and high level of hsCRP were independent risk factors for long-term HF.4.The FT3+LVEF combination might be a valuable predictor of long-term HF after AMI.5.The group with low FT3 and LVEF had highest risk of long-term HF after AMI.