The purpose: to determine the predictors of adverse course of heart failure (HF), taking into account the thyroid status of patients.
Materials and methods. 157 patients with HF (with myocardial infarction) were examined. On admission a standardized physical examination was carried out, the parameters of intracardiac hemodynamics, clinical and biochemical blood tests, and levels of thyroid hormones were evaluated.
Results and discussion. It was determined that the risk of re-hospitalization due to decompensation of the HF increases when the optimal separation point for the serum T3f level ≤ 2.07 pmol / l is exceeded (sensitivity - 67.77% and specificity - 71.05%, p = 0.0017). The relative risk of re-hospitalization of patients with HF during 2 years, with a level of T3f ≤ 2.07 pmol / l, is 2.224 [1.363 - 3.630] (p <0.05). By means of automatic regression analysis, a model of the re-hospitalization of patients with HF due to decompensation of the disease within 2 years was built. It includes: body mass (a = 0.009, p = 0.0001), T3f level (a = - 0.122, p = 0.0001), presence of non-toxic goiter (a = 0.340, p = 0.001), the level of LDL cholesterol (a = 0.116, p = 0.002) and total cholesterol (a = –0.072, p = 0.002), the relative content of granulocytes in blood (a = –0.007, p = 0.017), the concentration of T4f (a = 0.013, p = 0.026). According to ROC analysis the risk of re-hospitalization of patients increases when the optimal separation point for the regression model equation exceeds ≥ 1,321 conventional units (CU) is (sensitivity - 93.78% and specificity - 40, 45%, p = 0.0001).
Conclusions. Taking into account the obtained data on the effect of a decrease in the serum T3 level on the course of HF, it is possible to assume that as a predictor of an unfavorable course of the disease, it is advisable to use its value ≤ 2.07 pmol / l. The regression model of the re-hospitalization of patients with HF includes: body mass, concentrations of thyroxin and triiodthyronin, the presence of non-toxic goiter, growth, levels of total and LDL cholesterol, blood granulocytes relative content. The risk of re-hospitalization of patients with HF, due to decompensation of the disease, increases when the regression equation of the model ≥ 1,321 conventional units is exceeded.
Key words: heart failure, triiodothyronine, thyroxin, course of the disease, regression model.