Subclinical Hypothyroidism as an Independent Predictor of Cardiovascular Prognosis in Left Ventricular Thrombus Patients

Objectives: Left ventricular thrombus (LVT) is associated with an increased risk of adverse cardiovascular events, and thyroid hormones are known to affect the cardiovascular system in various ways. However, subclinical thyroid dysfunction still deserves to be emphasized, and its impact on the prognosis of patients with LVT is rare but needs to be investigated. Methods: We used retrospective data from patients diagnosed with LVT at Fuwai Hospital over the past 10 years to assess the relationship between thyroid functional status and prognosis of LVT using multivariate Cox proportional hazards models and validated the improved predictive effect of including thyroid function in the prognostic assessment of LVT using receiver operating characteristic curves. Results: Subclinical hypothyroidism was significantly associated with a higher incidence of major adverse cardiovascular and cerebrovascular events (MACCEs) [hazard ratio (HR) 1.774, 95% confidence interval (CI): 1.053-2.989; P = .031] and cardiovascular death (HR 1.986, 95% CI: 1.110-3.553; P = .021) in LVT patients, whereas no significant correlation was observed in the subclinical hyperthyroidism group. In addition, including thyroid function in the prognostic consideration of LVT patients would contribute to the predictive effect of MACCEs [area under the curve (AUC) for 1 year: 0.715; AUC for 2 years: 0.745; AUC for 3 years: 0.684]. Conclusion: Subclinical hypothyroidism can be used as an independent predictor of MACCEs in patients with LVT, and there is a clinical value in using subclinical hypothyroidism as an important factor suggesting a poor prognosis in patients with LVT.