He Hui, Wang Jun, Xia Long, Ye Tao, Luo Yan, Chen Qiang, Feng Qiao, Peng Xiufen, Jiang Maoling, Liu Hanxiong, Xiang Tao, Xiong Shiqiang, Cai Lin
Department of Cardiology, The Affiliated Hospital, Southwest Medical University, Luzhou, Sichuan, China.
Department of Intensive Care Unit, Jinniu District People's Hospital, Jinniu Hospital of Sichuan Provincial People's Hospital, Chengdu, Sichuan, China.
Front Endocrinol (Lausanne). 2025 Jul 2;16:1543378. doi: 10.3389/fendo.2025.1543378. eCollection 2025.
The thyroid hormone sensitivity index provides a new perspective for investigating nuanced alterations in thyroid function in cardiovascular disorders. However, the predictive value of thyroid hormone sensitivity indices for adverse events following percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS) patients remains unknown. This study aimed to investigate the predictive value of thyroid sensitivity indices for major adverse cardiac and cerebrovascular events (MACCEs) in these patients.
A total of 431 patients were included in the analysis. Thyroid hormone sensitivity indices were calculated using the thyroid-stimulating hormone index (TSHI), thyrotrophic thyroxine resistance index (TT4RI), thyroid feedback quantile-based index (TFQI), and parametric thyroid feedback quantile-based index (PTFQI). During the median follow-up period, 50 (11.60%) patients experienced MACCEs. Multivariate Cox regression analysis revealed that TSHI (HR 1.277, 95% CI 1.110-1.468, P<0.001), TT4RI (HR 1.002, 95% CI 1.001-1.003, P<0.001), TFQI (HR 1.130, 95% CI 1.043-1.224, P=0.003), and PTFQI (HR 1.237, 95% CI 1.107-1.383, P<0.001) were independent predictors of MACCEs. The area under the ROC curve (AUROC) revealed that PTFQI had the highest predictive value (AUROC =0.688, 95% CI: 0.595-0.780; P < 0.001). Adding PTFQI to the GRACE score can enhance the risk prediction of MACCEs in ACS patients undergoing PCI, AUROC = 0.759 (95% CI 0.676-0.842, P < 0.001) vs AUROC = 0.646 (95% CI 0.563-0.729, P = 0.001), and there is a significant difference (P = 0.0108). Subgroup analysis indicated that PTFQI had a more significant predictive value for MACCEs in males and patients with abnormal blood glucose.
Thyroid hormone sensitivity indices are associated with a greater risk of MACCEs in patients with ACS following PCI.
甲状腺激素敏感性指数为研究心血管疾病中甲状腺功能的细微变化提供了新视角。然而，甲状腺激素敏感性指数对急性冠状动脉综合征（ACS）患者经皮冠状动脉介入治疗（PCI）后不良事件的预测价值尚不清楚。本研究旨在探讨甲状腺敏感性指数对这些患者主要不良心脑血管事件（MACCEs）的预测价值。
共纳入431例患者进行分析。使用促甲状腺激素指数（TSHI）、促甲状腺素甲状腺素抵抗指数（TT4RI）、基于甲状腺反馈分位数的指数（TFQI）和基于参数甲状腺反馈分位数的指数（PTFQI）计算甲状腺激素敏感性指数。在中位随访期内，50例（11.60%）患者发生MACCEs。多因素Cox回归分析显示，TSHI（HR 1.277，95%CI 1.110 - 1.468，P<0.001）、TT4RI（HR 1.002，95%CI 1.001 - 1.003，P<0.001）、TFQI（HR 1.130，95%CI 1.043 - 1.224，P = 0.003）和PTFQI（HR 1.237，95%CI 1.107 - 1.383，P<0.001）是MACCEs的独立预测因素。ROC曲线下面积（AUROC）显示，PTFQI具有最高的预测价值（AUROC = 0.688，95%CI：0.595 - 0.780；P < 0.001）。将PTFQI加入GRACE评分可提高接受PCI的ACS患者MACCEs的风险预测能力，AUROC = 0.759（95%CI 0.676 - 0.842，P < 0.001）对比AUROC = 0.646（95%CI 0.563 - 0.729，P = 0.001），且存在显著差异（P = 0.0108）。亚组分析表明，PTFQI对男性和血糖异常患者的MACCEs具有更显著的预测价值。
甲状腺激素敏感性指数与PCI术后ACS患者发生MACCEs的风险较高相关。
