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Thyroid dysfunction is known to effect cardiac function and is a risk factor for developing heart failure (HF). Data regarding the clinical significance of thyroid‐stimulating hormone (TSH) levels alone as a predictor of outcome in patients with HF is sparse. We evaluated the significance of TSH on clinical outcome in a large cohort of patients with chronic HF.

Patients with a diagnosis of HF at a Health Maintenance Organization (n = 5599) were followed for cardiac‐related hospitalizations and death. Median TSH levels were 2.2 mIU/L (interquartile range 1.4–3.5). We divided patients into quartiles based on TSH levels. Median follow‐up time was 434 days and the overall mortality rate was 13.2%. Both a high and a low TSH level was associated with an increased mortality rate. Cox regression analysis after adjustment for other significant predictors demonstrated that the highest TSH …