Perfil dos hormônios tireoidianos nas síndromes coronarianas agudas

Pimentel, Rodrigo Caetano; Cardoso, Gilberto Perez; Escosteguy, Cláudia Caminha; Abreu, Luiz Maurino

doi:10.1590/s0066-782x2006001900002

Cited by 8 publications

(3 citation statements)

References 20 publications

(18 reference statements)

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“…This pattern of thyroid hormone alterations was described in several scenarios of acute or chronic illness ( 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ). In addition, there is a significant correlation between altered thyroid hormone levels and the severity and duration of disease ( 9 , 10 , 11 , 12 , 17 , 18 , 19 , 20 ). Several studies found an association between low T3 and disease severity.…”

Section: Introductionmentioning

confidence: 78%

“…T3 levels both on time 0 (admission) or time 1 had a good accuracy to predict short- and long-term mortality, comparable to other prognostic validated clinical scores. Accordingly, it was previously suggested that adding T3 to other severity scores ( 9 , 29 , 41 ). Moreover, serum T3 is an easy, reliable, and applicable test that can, individually or in combination with the other severity scores, increase the sensitivity to highlight those patients with a worse prognosis.…”

Section: Discussionmentioning

confidence: 99%

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T3 as predictor of mortality in any cause non-critically ill patients

Biegelmeyer

Scanagata

Alves

et al. 2021

Endocrine Connections

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Background: Low T3 syndrome refers to a set of thyroid hormone metabolism alterations present in disease state. A correlation between low T3 and poor clinical outcomes in the intensive care unit is more established. Nonetheless, studies on non-critically ill patients are few and controversial. Objective: To evaluate the prevalence and predictive value of low T3 levels on 30 days- and six month-term mortality in non-critically ill patients. Secondary outcomes evaluated length of hospital stay, overall mortality, and hospital readmission. Design: Prospective cohort study. Methods: 345 consecutive patients from Internal medicine ward of a tertiary hospital in southern Brazil included from October 2018 to April 2019 and followed for 6 months. Levels of total serum T3 were measured weekly, from admission to discharge, and correlated with 30-day hospital mortality. Results: Prevalence of low T3 was 36.6%. Low T3 levels were associated with higher 30-days hospital mortality (15.1% versus 4.1%, p<0.001) and higher 6-months overall mortality (31.7% versus 13.2%, p<0.001). Total serum T3 at admission was an independent predictor of 30-days hospital mortality. Conclusion: Low T3 levels are a prevalent condition among non-critically ill patients and this condition is associated with poor clinical outcomes in this population. Total serum T3 levels, alone or in association with other predictive scores, were demonstrated to be an easy and valuable tool for risk stratification, and should be further employed in this setting.

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Section: Introductionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

T3 as predictor of mortality in any cause non-critically ill patients

Biegelmeyer

Scanagata

Alves

et al. 2021

Endocrine Connections

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“…Several studies have reported about NTIS in subjects with AMI [ 3 , 6 , 7 , 10 ]. In AMI condition, decrease of free T3 and increase of reverse T3 have been documented [ 15 , 16 ]. In animal models, Ojamaa et al [ 17 ] showed that low T3 levels fell within 1 week of AMI and remained > 40% lower than those in controls 4 weeks after AMI.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of total triiodothyronine and free thyroxine levels for the heart failure in patients with acute myocardial infarction

Kang

Hahm

Kim

et al. 2018

Korean J Intern Med

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Background/AimsAlthough a low triiodothyronine (T3) state is closely associated with heart failure (HF), it is uncertain whether total T3 levels on admission is correlated with the clinical outcomes of acute myocardial infarction (AMI). The aim of this study is to investigate the prognostic value of total T3 levels for major adverse cardiovascular and cerebrovascular events (MACCEs) in patients with AMI undergone percutaneous coronary intervention (PCI).MethodsA total of 765 PCI-treated AMI patients (65.4 ± 12.6 years old, 215 women) between January 2012 and July 2014 were included and 1-year MACCEs were analyzed. We assessed the correlation of total T3 and free thyroxine (fT4) with prevalence of 1-year MACCEs and the predictive values of total T3, fT4, and the ratio of total T3 to fT4 (T3/fT4), especially for HF requiring re-hospitalization.ResultsThirty patients (3.9%) were re-hospitalized within 12 months to control HF symptoms. Total T3 levels were lower in the HF group than in the non-HF group (84.32 ± 21.04 ng/dL vs. 101.20 ± 20.30 ng/dL, p < 0.001). Receiver operating characteristic curve analysis showed the cut-offs of total T3 levels (≤ 85 ng/dL) and T3/fT4 (≤ 60) for HF (area under curve [AUC] = 0.734, p < 0.001; AUC = 0.774, p < 0.001, respectively). In multivariate analysis, lower T3/fT4 was an independent predictor for 1-year HF in PCI-treated AMI patients (odds ratio, 1.035; 95% confidential interval, 1.007 to 1.064; p = 0.015).ConclusionsLower levels of total T3 were well correlated with 1-year HF in PCI-treated AMI patients. The T3/fT4 levels can be an additional marker to predict HF.

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Thyroid hormones and heart failure

Martínez

2016

Heart Fail Rev

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Heart failure is a major health problem and its relationship to thyroid dysfunction has been increasingly investigated in recent years. Since it has been demonstrated that thyroid hormones (TH) and mainly T3 have cardioprotective effects, it is easy to understand that in the scenario of thyroid disorder, cardiac function may be damaged, and inversely in cardiac dysfunction thyroid dysregulation may be seen. The increase in plasma TH produces a clear neurohormonal activation which impacts negatively on cardiac function. In hypothyroidism, and in addition to extracardiac dysfunction, myocardial and vascular remodelling is altered and they contribute to cardiac failure. Abnormal low plasma TSH has also been shown to be a risk factor for developing HF in several recent studies, and they suggest that TSH is an independent predictor of clinical outcome including death and cardiac hospitalizations. Therefore, physicians should consider all these concepts when managing a patient with heart failure, not only for a clear diagnosis, but also for better and accurate treatment.

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Perfil dos hormônios tireoidianos nas síndromes coronarianas agudas

Cited by 8 publications

References 20 publications

T3 as predictor of mortality in any cause non-critically ill patients

T3 as predictor of mortality in any cause non-critically ill patients

Prognostic value of total triiodothyronine and free thyroxine levels for the heart failure in patients with acute myocardial infarction

Thyroid hormones and heart failure

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