游离三碘甲状腺原氨酸水平对心血管事件的影响

Relationship of Free T3 with occurrence of major adverse cardiac event

目的研究血游离三碘甲状腺原氨酸(FT3)对主要心血管事件发生的影响。方法回顾性分析1 154例可疑冠心病且行冠状动脉双源CT和FT3检测的门诊患者,随访所有符合入选标准的患者(7~30个月),记录主要心血管事件(MACE,包括死亡、心肌梗死、冠状动脉支架置入术、冠状动脉旁路移植术)的发生。根据患者FT3水平分为正常FT3组(n=902)和低FT3组(n=252);采用Kaplan-meier进行生存率分析,logistic逐步回归分析MACE的相关因素。结果低FT3组(FT3<3.5 pmol/L)的冠状动脉钙化负荷[147.6(53.86±00.1)Vs.34.5(0 262.7),P<0.001]和MACE发生率明显高于正常FT3组[7.9%(20/252)Vs.2.0%(18/902),P=0.002];Kaplan-meier分析显示低FT3组患者累积生存率明显低于正常FT3组,差异有统计学意义(P=0.004)。结论血游离三碘甲状腺原氨酸是心血管事件发生的重要影响因素,而且低FT3水平是心血管事件发生的危险因素。

Objective To survey the effect of serum free triiodothyronine levels on the occurrence of major adverse cardi- ac events （MACE） of the outpatients with suspected coronary artery disease during follow - up time. Methods A total of 1154 outpatients with suspected CAD, who under, cent dual - source computed tomography and FT3 detection and ac- cepted follow -up （7 -30 months） for the major adverse cardiac events （death, MI, PCI, CABG） were analyzed retro- spectively. These patients were divided into low FT3 （ n = 252 ） and normal FT3 （ n = 902 ） group based on the FT3 lev- el. The survival rates were analyzed using Kaplan - meier, and the related factors to MACE were analyzed using logistic regression （stepwise） analysis. Results The normal FT3 levels （ ≥ 3.5pmol/L ） group had lower CACS [ 34. 5 （0 262. 7） vs. 147.6（53.8 600. 1 ） ,P 〈 0. 001 ] burden and lower incidence rate of MACE （2. 0% vs. 7.9%, P = 0. 002 ） than the group with low FT3 （FT3 〈 3.5pmol/L）. A Kaplan - Meier analysis displayed that those patients with low FT3 levels had a lower cumulative survival rate than those with normal FT3 levels （P = 0. 004）. Conclusion FT3 levels were associated with the incidence rate of MACE in patients with suspected coronary artery disease. And a low FT3 level is considered as an important risk factor of incidence of MACE.