Impact of thyroid dysfunction on short-term outcomes and long-term mortality in patients with pulmonary embolism
Background - A large body of evidence suggest an impact of thyroid function on outcomes of cardiovascular diseases, but results for acute pulmonary embolism (PE) are sparse. - Methods - We analysed the impact of hypothyroidism as well as hyperthyroidism on the short and long-term outcomes of patient...
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| Main Authors: | , , , , , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
31 January 2022
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| In: |
Thrombosis research
Year: 2022, Volume: 211, Pages: 70-78 |
| ISSN: | 1879-2472 |
| DOI: | 10.1016/j.thromres.2022.01.014 |
| Online Access: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1016/j.thromres.2022.01.014 Verlag, lizenzpflichtig, Volltext: https://www.sciencedirect.com/science/article/pii/S0049384822000147 
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| Author Notes: | Kristina R. Pohl, Lukas Hobohm, Valentin J. Krieg, Carmen Sentler, Nina I.J. Rogge, Laura Steimke, Matthias Ebner, Markus Lerchbaumer, Gerd Hasenfuß, Stavros Konstantinides, Mareike Lankeit, Karsten Keller |
| Summary: | Background - A large body of evidence suggest an impact of thyroid function on outcomes of cardiovascular diseases, but results for acute pulmonary embolism (PE) are sparse. - Methods - We analysed the impact of hypothyroidism as well as hyperthyroidism on the short and long-term outcomes of patients with acute PE. The impact was compared to the group of euthyroid PE patients as reference group. - Results - Overall, 831 PE patients (median age 69 [IQR 56-77] years; 52.2% females) were analysed. Among these, 734 patients (88.3%) were classified as euthyroid, 40 (4.8%) as hypothyroid and 57 (6.9%) as hyperthyroid. PE patients with hypothyroidism had higher rates of adverse in-hospital outcomes (37.5% vs. 11.6%, P < 0.001), PE-related (22.5% vs. 4.8%, P < 0.001) and all-cause in-hospital death (25.0% vs. 6.8%, P < 0.001), whereas hyperthyroidism did not affect in-hospital outcomes. Long-term mortality was higher in hypothyroidism (52.5% vs. 28.9%, P = 0.002) and hyperthyroidism (43.9% vs. 28.9%, P = 0.018) compared to euthyroid function. In the 750 normotensive PE patients, hyperthyroidism affected adverse in-hospital outcome (OR 2.58 [95%CI 1.12-5.97], P = 0.026) and PE-related in-hospital mortality (OR 3.50 [95%CI 1.10-11.17], P = 0.035) in comparison to euthyroid PE patients, while hypothyroidism showed no influence. Elevated fT4 (HR 1.75 [95%CI 1.16-2.63], P = 0.007) and reduced fT3 values (HR 2.51 [95%CI 1.48-4.28], P = 0.001) were associated with increased long-term mortality. - Conclusion - Thyroid dysfunction had a substantial impact on short and long-term outcomes of patients with acute PE. Elevated fT4 and reduced fT3 values were significantly associated with increased long-term mortality in normotensive PE patients. |
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| Item Description: | Gesehen am 19.07.2022 |
| Physical Description: | Online Resource |
| ISSN: | 1879-2472 |
| DOI: | 10.1016/j.thromres.2022.01.014 |