Another study on Thyroid function and Heart Failure that relies on TSH only

[holyshedballs]

pubmed.ncbi.nlm.nih.gov/331...

Relation Between Thyroid Function and Mortality in Patients With Chronic Heart Failure

Nathan A Samuel , Joseph J Cuthbert , Oliver I Brown , Syed Kazmi , John G F Cleland , Alan S Rigby , Andrew L Clark

PMID: 33115640 DOI: 10.1016/j.amjcard.2020.10.034

Mixed messaging and regarding the role of TSH. The study concludes: "although thyroid dysfunction is associated with worse survival in patients with CHF, it is not an independent predictor of mortality".

It is another "association" study, with no direct evidence that TSH has any effect on the heart. Nevertheless, it concludes TSH is not an independent predictor of mortality.

Abstract here:

Abstract

Thyroid dysfunction is common in patients with chronic heart failure (CHF), but there is conflicting evidence regarding its prognostic significance. We investigated the relation between thyroid function and prognosis in a large, well characterized cohort of ambulatory patients with CHF. Heart failure was defined as signs and symptoms of the disease and either left ventricular systolic dysfunction (LVSD) mild or worse (heart failure with reduced ejection fraction [HFrEF]), or no LVSD and raised amino-terminal pro-B-type natriuretic peptide (NT-proBNP) levels (>125 ng/L; heart failure with normal ejection fraction [HFnEF]). Euthyroid state was defined as a thyroid-stimulating hormone (TSH) level between 0.35 and 4.70 mIU/l, hypothyroidism as TSH >4.70 mIU/l, and hyperthyroidism as TSH <0.35 mIU/l. 2997 patients had HFrEF and 1995 patients had HFnEF. 4491 (90%) patients were euthyroid, 312 (6%) were hypothyroid, and 189 (4%) were hyperthyroid. In univariable analysis, both hypothyroid patients (hazard ratio [HR] 1.25, 95% confidence interval [CI] 1.08 to 1.45) and hyperthyroid patients (HR 1.21, 95% CI 1.01 to 1.46) had a greater risk of death compared with euthyroid patients. There was a U-shaped relation between TSH and outcome. Increasing TSH was a predictor of mortality in univariable analysis (HR 1.02, 95% CI 1.01 to 1.03), but the association disappeared in multivariable analysis. The three strongest predictors of adverse outcome were increasing age, increasing NT-proBNP, and higher NYHA class. In conclusion, although thyroid dysfunction is associated with worse survival in patients with CHF, it is not an independent predictor of mortality.

Copyright © 2020 Elsevier Inc. All rights reserved.

[diogenes Remembering]

This equally recent paper says the opposite and explains why TSH may mistakenly be a sign or a predictor of cardiac problems:

PERSPECTIVE ARTICLE

Front. Endocrinol., 26 October 2020 | doi.org/10.3389/fendo.2020....

The Two Faces of Janus: Why Thyrotropin as a Cardiovascular Risk Factor May Be an Ambiguous Target

Johannes Wolfgang Dietrich, Rudolf Hoermann, John E. M. Midgley, Friederike Bergen and Patrick Müller

[diogenes Remembering in reply to diogenes]

The greatest difficulty in relating thyroid/pituitary function to nonthyroidal disease and subclinical hypothyroidism (TSH only raised) is to separate influence from consequence. Does the thyroid change instigate the disease or is it a more inconsequential result from the action of the disease itself, having to respond appropriately? We believe the latter whereas most others believe the former especially in cardiac problems.

[penny]

By using the TSH as a predictor of thyroid status they have negated the study, imho.

[tattybogle]

another fine example of 'garbage in =garbage out'

Did they not bother recording who if anyone was taking thyroid hormones etc, etc .... i can't be bothered to read it and find out , cos it's obviously not worth reading.

[Catseyes235]

Interesting though that at least someone is exploring this.