Pyvovar S. Optimisation of prognosis of the clinical outcome and effectiveness of heart failure treatment in patients with coronary artery disease with concomitant thyroid pathology.

The study aims to improve prognosis of the clinical outcome and to optimise heart failure (HF) treatment in patients with coronary artery disease combined with thyroid pathology (TP) on the basis of hormonal and genetic factors study. The results are based on the examination data collected from 381 patients with HF on the background of coronary artery disease: post-infarction cardiosclerosis. The main group consisted of 218 patients with HP and concomitant TP (92 with non-toxic goiter; 126 with autoimmune thyroiditis), the comparison group consisted of 163 patients with HF without TP. 55 healthy volunteers made up the control group. It has been proved, that patients with TP have a less favourable HF outcome. One of the possible causes is the considerable frequency of low triiodothyronine syndrome (LT3S). In particular, among patients with HF, the percentage of individuals with LT3S constitutes 7.3 %, and it reaches 38.4 % in the presence of concomitant TP. The risk of adverse HF outcome increases with decrease of T3f levels ? 2.07 pmol / L. It has been substantiated that it is advisable to distinguish the outcome of HF with LT3S as a separate classification variant, taking into account the following: the negative impact of LT3S on the HF outcome; common genetic factors of unfavourable clinical outcome HF and LT3S risks increase; the neutralization of a dose-dependent effect of ?-blockers in patients of this category. The bisoprolol dose titration scheme for HF in patients with concomitant TP has been optimised.