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Low T3 syndrome is associated with 30-day mortality in adult patients with fulminant myocarditis
BACKGROUND: Fulminant myocarditis (FM) is a critical disease with high early mortality. Low triiodothyronine syndrome (LT3S) was a strong predictor of poor prognosis of critical diseases. This study investigated whether LT3S was associated with 30-day mortality in FM patients. METHODS: Ninety-six FM...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10264897/ https://www.ncbi.nlm.nih.gov/pubmed/37324269 http://dx.doi.org/10.3389/fendo.2023.1164444 |
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author | Miao, Guangrui Pang, Shuo Zhou, Yuanhang Duan, Mingxuan Bai, Linpeng Zhao, Xiaoyan |
author_facet | Miao, Guangrui Pang, Shuo Zhou, Yuanhang Duan, Mingxuan Bai, Linpeng Zhao, Xiaoyan |
author_sort | Miao, Guangrui |
collection | PubMed |
description | BACKGROUND: Fulminant myocarditis (FM) is a critical disease with high early mortality. Low triiodothyronine syndrome (LT3S) was a strong predictor of poor prognosis of critical diseases. This study investigated whether LT3S was associated with 30-day mortality in FM patients. METHODS: Ninety-six FM patients were divided into LT3S (n=39, 40%) and normal free triiodothyronine (FT3) (n=57, 60%) groups based on serum FT3 level. Univariable and multivariable logistic regression analyses were performed to identify independent predictors of 30-day mortality. Kaplan–Meier curve was used to compare 30-day mortality between two groups. Receiver operating characteristic (ROC) curve and decision curve analysis (DCA) were used to assess the value of FT3 level for 30-day mortality prediction. RESULTS: Compared to normal FT3 group, LT3S group had higher incidence of ventricular arrhythmias, worse hemodynamics, worse cardiac function, more severe kidney impairment, and higher 30-day mortality (48.7% vs. 12.3%, P<0.001). In univariable analysis, LT3S (odds ratio [OR]:6.786, 95% confidence interval [CI]:2.472-18.629, P<0.001) and serum FT3 (OR:0.272, 95%CI:0.139-0.532, P<0.001) were significant strong predictors of 30-day mortality. After adjustment for confounders in multivariable analysis, LT3S (OR:3.409, 95%CI:1.019-11.413, P=0.047) and serum FT3 (OR:0.408, 95%CI:0.199-0.837, P=0.014) remained independent 30-day mortality predictors. The area under the ROC curve of FT3 level was 0.774 (cut-off: 3.58, sensitivity: 88.46%, specificity: 62.86%). In DCA, FT3 level showed good clinical-application value for 30-day mortality prediction. CONCLUSION: In FM patients, LT3S could independently predict 30-day mortality. FT3 level was a strong 30-day mortality predictor and a potentially useful risk-stratification biomarker. |
format | Online Article Text |
id | pubmed-10264897 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-102648972023-06-15 Low T3 syndrome is associated with 30-day mortality in adult patients with fulminant myocarditis Miao, Guangrui Pang, Shuo Zhou, Yuanhang Duan, Mingxuan Bai, Linpeng Zhao, Xiaoyan Front Endocrinol (Lausanne) Endocrinology BACKGROUND: Fulminant myocarditis (FM) is a critical disease with high early mortality. Low triiodothyronine syndrome (LT3S) was a strong predictor of poor prognosis of critical diseases. This study investigated whether LT3S was associated with 30-day mortality in FM patients. METHODS: Ninety-six FM patients were divided into LT3S (n=39, 40%) and normal free triiodothyronine (FT3) (n=57, 60%) groups based on serum FT3 level. Univariable and multivariable logistic regression analyses were performed to identify independent predictors of 30-day mortality. Kaplan–Meier curve was used to compare 30-day mortality between two groups. Receiver operating characteristic (ROC) curve and decision curve analysis (DCA) were used to assess the value of FT3 level for 30-day mortality prediction. RESULTS: Compared to normal FT3 group, LT3S group had higher incidence of ventricular arrhythmias, worse hemodynamics, worse cardiac function, more severe kidney impairment, and higher 30-day mortality (48.7% vs. 12.3%, P<0.001). In univariable analysis, LT3S (odds ratio [OR]:6.786, 95% confidence interval [CI]:2.472-18.629, P<0.001) and serum FT3 (OR:0.272, 95%CI:0.139-0.532, P<0.001) were significant strong predictors of 30-day mortality. After adjustment for confounders in multivariable analysis, LT3S (OR:3.409, 95%CI:1.019-11.413, P=0.047) and serum FT3 (OR:0.408, 95%CI:0.199-0.837, P=0.014) remained independent 30-day mortality predictors. The area under the ROC curve of FT3 level was 0.774 (cut-off: 3.58, sensitivity: 88.46%, specificity: 62.86%). In DCA, FT3 level showed good clinical-application value for 30-day mortality prediction. CONCLUSION: In FM patients, LT3S could independently predict 30-day mortality. FT3 level was a strong 30-day mortality predictor and a potentially useful risk-stratification biomarker. Frontiers Media S.A. 2023-05-31 /pmc/articles/PMC10264897/ /pubmed/37324269 http://dx.doi.org/10.3389/fendo.2023.1164444 Text en Copyright © 2023 Miao, Pang, Zhou, Duan, Bai and Zhao https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Endocrinology Miao, Guangrui Pang, Shuo Zhou, Yuanhang Duan, Mingxuan Bai, Linpeng Zhao, Xiaoyan Low T3 syndrome is associated with 30-day mortality in adult patients with fulminant myocarditis |
title | Low T3 syndrome is associated with 30-day mortality in adult patients with fulminant myocarditis |
title_full | Low T3 syndrome is associated with 30-day mortality in adult patients with fulminant myocarditis |
title_fullStr | Low T3 syndrome is associated with 30-day mortality in adult patients with fulminant myocarditis |
title_full_unstemmed | Low T3 syndrome is associated with 30-day mortality in adult patients with fulminant myocarditis |
title_short | Low T3 syndrome is associated with 30-day mortality in adult patients with fulminant myocarditis |
title_sort | low t3 syndrome is associated with 30-day mortality in adult patients with fulminant myocarditis |
topic | Endocrinology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10264897/ https://www.ncbi.nlm.nih.gov/pubmed/37324269 http://dx.doi.org/10.3389/fendo.2023.1164444 |
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