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Low free triiodothyronine is associated with contrast-induced acute kidney injury and long-term outcome in elderly patients who underwent percutaneous coronary intervention [Anatol J Cardiol]
Anatol J Cardiol. 2019; 21(2): 60-67 | DOI: 10.14744/AnatolJCardiol.2018.38228  

Low free triiodothyronine is associated with contrast-induced acute kidney injury and long-term outcome in elderly patients who underwent percutaneous coronary intervention

Chunjin Lin1, Zhebin You1, Weiping Zheng1, Fan Lin1, Tailin Guo1, Kaiyang Lin2, Yansong Guo2, Pengli Zhu1
1Department of Geriatric Medicine, Fujian Provincial Hospital, Fujian Key Laboratory of Geriatrics, Fujian Provincial Center for Geriatrics, Fujian Medical University; Fuzhou-China
2Department of Cardiology, Fujian Provincial Hospital, Fujian Medical University, Fujian Cardiovascular Institute; Fuzhou-China

Objective: Low free triiodothyronine (fT3) is common in elderly patients with cardiovascular disease. The purpose of this study was to evaluate the relationship between low fT3 and contrast-induced acute kidney injury (CI-AKI), including the long-term outcomes, in elderly patients after a percutaneous coronary intervention (PCI).
Methods: A total of 350 patients aged ≥75 years who underwent PCI between January 2012 and December 2015 were consecutively enrolled. The perioperative thyroid function, including fT3, was measured before PCI. A low fT3 was defined as fT3 <3.1 pmol/L with normal thyrotropin and free thyroxine. CI-AKI was defined as an absolute serum creatinine (SCr) increase ≥0.30 mg/dL or a relative increase in SCr ≥50% from the baseline value within 48 hours after contrast media exposure. A multivariate logistic regression analysis was applied to analyze whether low fT3 was an independent risk factor for CI-AKI. The Cox regression analysis was used to evaluate the relationship between low fT3 and long-term prognosis.
Results: A total of 46 (13.1%) patients developed CI-AKI. The incidence of CI-AKI was significantly higher in the low fT3 group than in the normal group (26.5% vs. 9.9%, p<0.01). A multivariable logistic analysis demonstrated that a low fT3 level was significantly related to CI-AKI [odds ratio (OR) =2.41; 95% confidence interval (CI), 1.115.27; p=0.027]. The Cox regression analysis showed that a low fT3 was associated with long-term mortality [adjusted hazard ratio (HR)= 2.00; 95% CI, 1.043.83; p=0.037] during the follow-up of mean 1.67 years.
Conclusion: A low fT3 concentration was independently associated with CI-AKI and poor prognosis in elderly patients who had undergone PCI.

Keywords: percutaneous coronary intervention, free triiodothyronine, contrast-induced acute kidney injury, long-term prognosis, elderly


Chunjin Lin, Zhebin You, Weiping Zheng, Fan Lin, Tailin Guo, Kaiyang Lin, Yansong Guo, Pengli Zhu. Low free triiodothyronine is associated with contrast-induced acute kidney injury and long-term outcome in elderly patients who underwent percutaneous coronary intervention. Anatol J Cardiol. 2019; 21(2): 60-67

Corresponding Author: Pengli Zhu, China


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