Little is known about the association between the free triiodothyronine/free thyroxine (FT3/FT4) ratio and clinical outcomes in euthyroid patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) undergoing percutaneous coronary intervention (PCI). A total of 1448 euthyroid patients with NSTE-ACS who underwent PCI were included in this prospective study. Multivariate Cox regression analysis revealed that there was a significantly increased risk of stroke (hazard ratio [HR] 11.380, 95% confidence interval [CI]: 1.386-93.410, P = .024) and major adverse cardiovascular and cerebrovascular events (MACCEs) (HR 3.364, 95% CI: 1.595-7.098, P = .001) in patients in lower FT3/FT4 tertiles. The combined model of FT3/FT4 ratio and the Global Registry of Acute Coronary Events (GRACE) score provided the added value of risk assessment by improving C-statistics, integrated discrimination improvement (IDI), and the net reclassification index (NRI) (all P < .05). Thus, in euthyroid patients with NSTE-ACS undergoing PCI, the FT3/FT4 ratio was not only an independent prognostic indicator of long-term MACCE but also enhanced risk discrimination when combined with the GRACE risk score, which suggests that the calculation of FT3/FT4 before and after PCI may contribute to risk stratification in this particular patient group.

中文翻译：

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FT3/FT4 增强了基于 GRACE 2.0 评分的非 ST 段抬高急性冠状动脉综合征患者接受经皮冠状动脉介入治疗的风险评估。

对于接受经皮冠状动脉介入治疗 (PCI) 的非 ST 段抬高急性冠状动脉综合征 (NSTE-ACS) 甲状腺功能正常患者的游离三碘甲状腺原氨酸/游离甲状腺素 (FT3/FT4) 比率与临床结果之间的关系知之甚少。这项前瞻性研究共纳入了 1448 名甲状腺功能正常且接受 PCI 的 NSTE-ACS 患者。多变量 Cox 回归分析显示，中风风险显着增加（风险比 [HR] 11.380，95% 置信区间 [CI]：1.386-93.410，P = 0.024）和主要不良心脑血管事件 (MACCE)（ FT3/FT4 较低三分位数的患者中，HR 3.364，95% CI：1.595-7.098，P = .001）。FT3/FT4 比率和全球急性冠脉事件登记 (GRACE) 评分的组合模型通过改进 C 统计、综合区分改进 (IDI) 和净重分类指数 (NRI)（所有P < .05)。因此，在接受 PCI 的甲状腺功能正常的 NSTE-ACS 患者中，FT3/FT4 比值不仅是长期 MACCE 的独立预后指标，而且与 GRACE 风险评分结合时可以增强风险辨别力，这表明 FT3/FT4 的计算PCI 前后的 FT4 可能有助于该特定患者组的风险分层。